Intake Coordinator at Access Infusion Care Inc – Kalispell, Montana

Position Summary

The Intake Coordinator is responsible for processing patient information during the intake process and ongoing coordination of patient services, following the guidelines set by the Health Insurance Portability and Accountability Act (HIPAA) regarding patient confidentiality and privacy or Protective Health Information (PHI). The Intake Coordinator is responsible for ensuring all required information and documentation is collected, uploaded, and clarified correctly to meet payor and regulatory requirements.

Reasonable Accommodation Statement

To perform this job successfully, an individual must be able to perform each essential duty listed below to a satisfactory level. Reasonable accommodation may be made to enable qualified individuals with disabilities to perform essential functions.

Job Duties

• Process intake information from referral sources and patients in a professional, knowledgeable, and courteous manner

• Maintain relationships with referral sources

• Maintain referral logs, including details related to declined referrals and the inability to meet patient needs, and distribute to supervisor

• Establish and maintain accurate and complete patient records

• Receive calls from new patients and referral sources, follow up with all messages left on voice mail, and document all communications accurately

• Route patient and prescriber incoming calls to the appropriate individual(s) in the facility

• Assist billing team with the verification of insurance for covered benefits, copay, and out of pocket amounts, and communicates this to patient; documents conversation with patients and patient acceptance/declination of financial responsibility

• Assist billing team with the re-verification of insurance coverage for current patients as needed

• Execute Prior Authorization (PA) forms when indicated

• Monitors expiration dates of PA and initiates new PA request in a timely fashion to ensure there are no delays in therapy

• Manage patient flow within the electronic medical record to ensure patient is ready to treat prior to appointment date

• Enroll patients in the appropriate copay assistance program and ensures approval and identification numbers are communicated to all necessary parties to assist with prompt reimbursement

• Monitor fax queue for new referrals and document all intake processes, including when referral was been received, insurance verification activities, communications with patients, prescribers, and third-party payors, and the initiation of financial hardship processes

• Communicate with Billing Specialists to ensure proper billing to insurance companies, contracts, other third-party payors, and patients for all products and services delivered

• Perform accurate data entry within electronic medical records and other required software

• Monitor trends and changes in pharmacy contract requirements to ensure that operations are within those contract guidelines

• Coordinate with facility clinical staff in the scheduling of patients for start of care

• Participate in surveys conducted by authorized inspection agencies

• Participate in the facility’s Quality Program and Compliance Program as requested by the Quality Coordinator and Compliance Officer

• Report any misconduct, suspicious, or unethical activities to the Compliance Officer

• Ensure ongoing compliance with all applicable laws and regulations, accreditation standards,and industry best practices

• Participate in education and training sessions provided by the company, as assigned by supervisor

• Participate in facility committees when requested

• Ensure the security and confidentiality of patient information and financial records

• Perform other duties as assigned by supervisor

Competency Statements

• Proven organizational skills with efficiency in multitasking   

• Strong problem-solving and critical thinking skills

• Excellent customer service and communication skills  

• Proficiency in maintaining clear and concise documentation  

• Accurate data entry skills with high attention to detail  

• Proficient understanding of basic medical terminology  

• In-depth knowledge of billing laws, regulations, and industry best practices

• Ability to carry out written and verbal directions

• Basic math, bookkeeping, and accounting skills

• Ability to work with various software tools and databases

• Previous experience working with electronic medical records and reimbursement software

Supervisory Responsibility

This role does not include supervisory responsibilities.

Work Environment

This job operates in an office-based setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines.

Potential Occupational Safety/Health Hazards

• Office hazards

• Personal safety hazards

• Fire hazards

• Ergonomic hazards

• Poor lighting and eye strain

Physical Requirements

This is a largely sedentary role with the physical abilities below being required:

Stand - F

Reach above shoulder - O

Walk - F

Climb - N

Sit - F

Crawl - N

Reach Outward - F

Squat/Kneel/Bend - O

Lift/Carry Push/Pull

10 lbs. or less - O

11-20 lbs. - O

21-50 lbs. - N

50+ lbs. - N

N (Not Applicable) Activity is not applicable to this role

O (Occasionally) Role requires this activity up to 33% of the time (0-2.5+ hrs./day)

F (Frequently) Role requires this activity up to 33%-66% of the time (2.5-5.5+ hrs./day)

C (Constantly) Role requires this activity up to 66% of the time (5.5+ hrs./day)

Position Type and Expected Hours of Work

This is a full-time position with typical working hours of 9:00 AM to 5:00 PM, Monday through Friday. Hours and work shifts may change in accordance with business needs.

Required Minimum Job Qualifications, Experience, Education, and Training

Education: High school Diploma or equivalent

Experience: 1+ year in a healthcare setting; Previous experience related to patient data collection, insurance verification, or patient scheduling

Computer Skills: Proficient skill level in Microsoft Office, Excel, and Word; Previous experience working with electronic medical records

Preferred Education and Experience

Education: Certified Intake and Scheduling Specialist (CISS); Previous training in Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS)

Experience: 2+ years in a patient intake, reimbursement, or care coordination role

Additional Eligibility Qualifications

Must be able to accomplish any and all duties with little to no assistance.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Expected Use and Disclosure of Protected Health Information

Employees in this position are expected to have access to protected health information and other confidential business information from throughout the organization as is needed to fulfill their responsibilities in evaluating and reducing risk to the organization. No protected health information will be disclosed outside the organization unless specifically required by state or federal law.

AAP/EEO Statement

Access Infusion Care is an Equal Employment Opportunity Employer. Employment decisions are made without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristics protected by law