Lead Intake Reimbursement Specialist

Fairview Health Services • Minneapolis, MN

9h

About The Position

As a member of the business office team, the Lead Intake Reimbursement Specialist uses strong customer service skills and knowledge of authorization and reimbursement practices to ensure patients fast, easy and appropriate access to pharmacy services. In addition, they train and enhance the competencies of the entire team. This position is a go to resource for the department and is a key member of the business office. The Lead Intake Reimbursement Specialist accepts and processes referrals, identifies payer sources, verifies benefit information and acquires initial authorization as needed to begin patient service or to determine denial of patient service. This position also follows up on pending unresolved coverage issues and claim denials and documents and communicates to appropriate providers and internal department's accurate authorization information on current or potential patients. This position may also complete the patient intake process, schedule patient appointments and partner with care team and external resources to ensure efficient patient flow as assigned This role will provide services for management of Fairview Homes Infusion as well as external customers. This includes consulting and training services for external consulting engagements.

Requirements

• 3 years Pharmacy setting or with revenue cycle, health insurance or benefit experience using an enterprise software system in healthcare or insurance organization

Nice To Haves

• B.S./B.A. Bachelors’ degree in business, communications, health care or related field.
• 3 years Revenue cycle, health insurance or benefits experience using an enterprise software system in the assigned clinical area or service line of a complex healthcare organization. Knowledge of ICD9 and ICD10 coding.
• Nationally certified. Certifying exams must have National Commission for Certifying Agencies (NCCA) accreditation, with examples including, Pharmacy Technician Certification Board (PTCB) exam and The Exam for Certification of Pharmacy Technicians (ExCPT).

Responsibilities

• Maintain strong knowledge of insurance, pharmacy practice, revenue cycle and in accordance with department Standard Operating Procedures (SOPs) and any regulatory or compliance requirements.
• Trains and orients new staff to their roles.
• Perform verification of insurance benefits, analysis and identify any potential coverage issues.
• Partner with potential international and self-pay patients on any financial or service needs related to their care as assigned.
• Serve as a resource to the affiliations, staff and physicians regarding Fairview’s pharmacy services in assigned area. Assist with the coordination of services by communicating effectively and in a timely manner with others.

Benefits

• Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: https://www.fairview.org/careers/benefits/noncontract

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees