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340B Claims Coordinator
2 months ago
Position: Claims Specialist
Department: 340B Referral Network
Summary
Kintegra Health is in search of a committed Claims Specialist to become a vital part of our 340B Referral Network team. This position involves collaborating with a dedicated group to enhance the referral management process, ensuring effective capture of 340B referrals.
Primary Responsibilities
- Adhere to 340B program regulations and guidelines while ensuring compliance with HIPAA to safeguard patient health information.
- Oversee state Medicaid claims to avert potential duplicate discount rebates and maintain compliance.
- Confirm patient eligibility through the EHR system, documenting interactions with both referring and referred-to healthcare providers.
- Gather and organize data to clarify the covered entity's obligations regarding patient care, including continuity of care documentation.
- Build and nurture relationships with internal teams to facilitate effective information exchange, enhancing program efficiency and growth.
- Utilize available resources to identify referral providers, medical specialty offices, and their contact details.
- Engage with external office personnel to verify referral-patient connections and securely transmit electronic facsimiles (eFax) of patient referral summaries recorded in medical records.
- Maintain the confidentiality and integrity of electronic patient health information using EPIC.
- Ensure accurate documentation is uploaded into the portal to support claims for 340B-eligible referrals.
- Complete 340B University to demonstrate a thorough understanding of the 340B program concerning referral capture and verification requirements for auditable records within the covered entity's patient EMR.
- Perform additional duties as needed to support departmental objectives.
Core Values
- Patient-Centric Approach: Prioritizing the well-being and preferences of patients.
- Focus on Improvement: Emphasizing process enhancement rather than assigning blame.
- Integrity and Transparency: Promoting openness, honesty, and fairness in all interactions, utilizing organizational resources responsibly.
- Team Collaboration: Committing to work as part of an interdependent team, ready to assist beyond the basic job description.
- Cultural Competence: Striving to enhance the ability to understand and interact effectively with diverse populations while being mindful of one's own cultural background.
Qualifications
- Significant experience with 340B referral relationships or relevant healthcare background.
- Certification as a Pharmacy Technician (CPhT) is preferred.
- Experience with EMR systems (minimum of 1 year preferred).
- Ability to adapt to changing priorities and demands.
Skills
- Proficient in advanced Excel functionalities.
- Strong verbal and written communication abilities.
- Meticulous attention to detail.
- Capable of collaborating with multiple parties to resolve issues effectively.
- 1+ years of experience in the 340B program is preferred.
About Kintegra Health
Kintegra Health is a community-focused, family-centered healthcare provider offering health education and preventive services without regard to patients' ability to pay. We prioritize alignment with our core values and seek staff who are dedicated to our mission, embodying the characteristics we uphold as we strive to serve our community members.
Our Objectives:
- To deliver comprehensive and accessible primary care services to individuals and families across all economic backgrounds.
- To address both physical and social health needs through timely diagnostics, treatment, and referral services.
- To emphasize preventive care through patient and community engagement.