Job Summary:

Responsible for performing the appropriate procedures to verify patient eligibility, coordinate benefits, run test claims, submit initial authorization and determine patient coverage/responsibility for services

Job Description: ​

Job Responsibilities

Performs Insurance Verification of benefit coverage on all of patient's insurance plans for each service being provided.

Obtains and documents in the system all information related to coinsurance, copay, deductibles, authorization requirements, etc.

Creates documentation required to service the patient per policy and payer guidelines.

Determines estimated patient financial responsibility using insurance verification information and payer contracts and/or self-pay guidelines.

Obtains initial authorization prior to admitting the patient for all services for any insurance plan that has authorization requirements.

Obtains reauthorization as necessary, reviews physician orders from pharmacy to determine if authorization is required on changes / additions to therapy for patients that are already on service.

Order entry

Calls patients and prescriber offices to schedule deliveries

Crosstraining in home infusion intake

Does this position have supervisory responsibilities? No

Basic Education and/or Experience Requirements

High school diploma

Basic Qualifications

Experience establishing and maintaining relationships with individuals at all levels of the organization.

Experience providing customer service to internal and external customers, including meeting quality standards of services and evaluation of customer satisfaction.

Basic PC skills including email, Microsoft Word, Excel and PowerPoint.

Experience in identifying operational issues and recommending process improvements.

Strong communication skills to speak with external service providers and internally with the AleraCare team to coordinate services.

Strong organizational skills.

Preferred Qualifications

Pharmacy technician license issued by the California State Board of Pharmacy

Prior experience in home infusion intake/specialty intake coordination

Previous Infusion Medical Billing/Collections or Intake/Admissions Experience