Intake/Reimbursement Specialist

Overview: We provide extensive home and outpatient infusion services to patients requiring IV therapy such as feeding by IV, infection treatment, chemotherapy, pain management and blood products/transfusions. Fairview Home Infusion is one of the largest home infusion organizations in the upper Midwest. It uses a care team structure—pharmacists, doctors, nurses, nutritionists, insurance experts—and customized operational services and reports to meet the needs of referring providers and patients. Our outpatient infusion centers provide chemotherapy and other infusion services along with clinical consultation and patient education. Specialized pharmacists work in collaboration with patients’ physicians and nurses to coordinate care at ambulatory suites throughout the Twin Cities and the surrounding Duluth area.Responsibilities/Job Description: Provide superior customer service to all internal and external customers. Accept and process all referrals, identify payor sources, verify benefit information and acquire initial authorization as needed to begin patient service or to determine denial of patient service. Takes initiatives to problem solve all questionable referrals to assure correct payor source. Follows up on pending unresolved coverage issues. Documents and communicates to appropriate providers and internal department’s accurate intake, benefit/authorization, and reauthorization information on current or potential patients. Utilize computer systems to enter and maintain accurate patient benefit information and to effectively communicate with case management staff, liaisons, social workers, physicians, clinics, Fairview teams or departments, staffers, billing/benefit staff and all others needing to make service related decisions.Qualifications: Minimum Education:
Vocational or Associates degree
Preferred Education
Bachelor’s degree in healthcare related field, pharmacy technician license

Minimum Experience:
Two years recent experience working in either a pharmacy setting or with health insurance/benefits.

Preferred Experience:
Insurance knowledge related to health care field, ICD10 coding knowledge.

Additional Requirements:
Customer service skills, critical thinking skills, ability to multi-task, computer database management, keyboarding, internet, email experience.