Intake Specialist - Remote

 

Job Summary:
Perform duties to process referrals with a focus on accuracy, timeliness, and adherence to process, to reduce denial rate, DSO, and bad debt. Recognize additional revenue opportunities, and improve collection rates, while working within the limits of standard or accepted practice.

Position is 100% remote

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Duties/Responsibilities:

• Review patient files for completeness and accuracy, identify and audit claims, ensure all revenue opportunities are included, and complete and submit billing, primary and secondary, to payers for reimbursement, via paper bills and clearinghouse submittals.
• Communicate effectively with franchise partners and other VCI departments regarding the status of order intake.
• Document case activity, communications, and correspondence in the computer system to ensure completeness and accuracy of account activity and actions are taken to resolve outstanding claims issues. Schedule follow-ups in required intervals.
• Investigate and verify benefits for pharmacy and medical third-party claims.
• Obtain prior authorizations; initiate request, follow up to provide the additional required information, track progress, and expedite responses from insurance carriers and other payers and maintain contact with customers to keep them continuously informed.
• Track, report, and escalate service issues arising from requests for authorizations or other issues that delay service, to ensure patient access and to avoid delays that may interrupt therapy.
• Communicate financial obligation information with patients so that they have a clear understanding of all costs of therapy prior to starting service.
• Contribute medical billing expertise to the design of training and knowledge transfer programs, materials, policies, and procedures to improve the efficiency and effectiveness of the RCM team. Assist with the processing of online adjudication of collection issues and nurse billing as assigned.
• Perform other related duties as assigned.

Required Skills/Abilities:

• Excellent communications skills; listening, speaking, understanding, and writing English while influencing patients, caregivers, payer representatives, and others, answering questions, and advancing reimbursement and collection efforts.
• Proven understanding of processes, systems, and techniques to ensure successful billing and collection working with all payer types.
• Proven ability to identify gaps and problems from a review of documentation, determine lasting solutions, make effective decisions, and take necessary corrective action.
• Strong organization skills with the ability to track and maintain clear, complete records of activities, cases, and related documentation.
• Proven knowledge and skill in the utilization of MS Office suite of software and pharmacy applications.

Education and Experience:

• High School Diploma or equivalent and additional specialized training in intake, pharmacy/medical billing, and/or collections.
• Two years’ Intake, Medical Billing, and/or Collections experience highly preferred. Some experience in Intake, Medical Billing, and/or Collections is required.
• Coding Course Certification is highly preferred.
• Experience in an infusion setting a plus.

Vital Care Infusion Services is an Equal Opportunity Employer.

#LI-remote

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