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Intake Specialist

3 months ago

Syracuse, New York, United States KPH Healthcare Services Full time

Overview:

Scope of Responsibilities: The Intake Specialist is an experienced individual who is able to assist and manage the referral intake process.

Job Summary: The Intake Coordinator is able to multitask utilizing excellent communication skills to ensure that the patient has adequate insurance or payor coverage for the infusion services that are being requested for AristaCare Health to provide. Then communicates the information obtained effectively to all members of the AristaCare Health team.

Responsibilities:

Job Duties:

  • Communicates in a timely manner the referral source (clinical liaison, discharge planner, medical social worker, clinic nurse) the patients insurance benefits and coverage or non- coverage for services that have been requested for AristaCare Health to provide.
  • Effectively communicates with insurance companies and their representatives, agency staff, referral source, patients and family the treatment plan that is being proposed by the referral source for the patient to discharge home safely. Explains the options that may be available for a positive financial patient outcome.
  • Obtains ALL the appropriate authorizations necessary from the patients insurance provider, then effectively documents ALL the information into the AristaCare Health system. Once authorization has been obtained then the Intake coordinator notifies the AristaCare Health team that the referral is ready to be serviced.
  • Participates in the Patient Referral Huddle Process, collects the AristaCare Health team and reviews each pending referral and the status of the referral and what still needs to be obtained to ensure a viable and safe referral.
  • Maintains all levels of confidentiality and follows HIPAA Guidelines regarding patient information and all proprietary AristaCare Health information.
  • Obtains and maintains positive relationships with internal AristaCare Health staff and external AristaCare Health staff.
  • May assist the referral source when asked in making additional arrangements for any special medical supplies, appliances or nursing services that may be needed for the patient to transition safely into the home setting or the Ambulatory Infusion Suite.
  • Effectively communicates with Marketing, Account Executives, and Pharmacy Staff with possible promotional and educational programs relating to different insurance plans and any changes that possibly may occur within the Insurance Payor, Medicare, or Medicaid
  • Responsible for completing all mandatory and regulatory training programs
  • Perform other duties as assigned
Qualifications:

Educational Requirements:

  • High School Diploma or Equivalent
Experience Preferred:
  • One year of intake experience and/or training; or equivalent combination of education and experience in the home health care field.
  • Basic knowledge of the Insurance approval/authorization process.

Special Conditions of Employment:

  • Criminal background check and/or drug test
  • Initial and continuous exclusion and sanction/disciplinary monitoring

Required Training:

  • HIPAA Privacy & Security Course
  • Fraud, Waste, and Abuse Course

Job Skills Required:

  • Exceptional attention to detail, strong customer service, interpersonal and communication skills
  • Must be able to effectively communicate internally and externally, via phone and through email
  • Strong PC skills required with a focus on Excel proficiency
  • Must be able to work independently

Behavioral Traits:

  • Intuitive/Open minded: Must be able to see opportunities, develop and implement creative solutions to complex problems
  • Achievement Drive/Commitment: Driven to achieve goals, objectives and results. Fosters a culture of continuous improvement
  • Positive/Supportive: Inspires and shows faith in others, builds a positive and supportive work environment
  • Flexibility: Ability to adapt to changing business needs. To balance multiple priorities and deliver under pressure

Attendance Requirements:

  • Must be available and on-time for scheduled work shifts