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Job: Lead Intake Specialist - 161888

This posting has expired and is no longer available.

Job Description

Summary: The Lead Intake Specialist will be responsible for direct oversite of the Intake Department and its activities from the initiation of a referral to the handoff to the Billing team.  These duties will include receiving patient information from referral sources, entering patient data into CPR +, Benefit Verification and Re-verification, initial Prior Authorization obtainment and renewal of authorizations for either initial setup or re-authorizations for services from the insurance companies. Incumbent will be the primary resource for branch personnel and billing teams for patient eligibility.  This position will accurately, thoroughly and in a time-sensitive manner process patient referrals and provide clear and timely communication to all stakeholders.
Essential Duties and Responsibilities include the following.  Other duties may be assigned. 
  • Perform accurate and timely insurance verification and accurately obtain patient specific benefit information and coverage guidelines.
  • Retrieve any documentation required to obtain the initial or re-authorization from the Payer.Obtain new authorizations when there are therapy changes.
  • Create all initial Consent Forms, LOAs, ABNs, payment plans and other patient specific paperwork for new admissions.
  • Review Held billing reports and expiring auth reports to resolve accounts that require follow up in order to comply with timely filing limits of the insurance company
  • Resolve held billing and inform billing team the patient is ready to bill.
  • Review adjustment request when required for authorizations that cannot be obtained
  • Understand and abide by Accreditation Commission for Health Care (ACHC) requirements
  • Working knowledge of the Advanced Beneficiary Notices (ABN)
  • Recognize when a concern should be recorded and utilize Concern Tracker appropriately
Education/Experience: H.S. Diploma required. College degree desirable. Minimum of one-year office experience. One to three years’ home infusion/home health experience preferred. Knowledge of Medicare coverage of DME helpful. Strong organizational, communication and leadership skills.