Intake Coordinator
The Intake Coordinator acts as a liaison between the referral source and the pharmacy to ensure a seamless transition from the acute care setting to home care for our patients.
Responsibilities include:
- Establishing and maintaining relationships with referral sources by receiving and processing intake information for potential patients who require home infusion therapy
- Facilitating the intake process by procuring all patient information necessary to determine home infusion admission based on supportive clinical data, prescribed therapy, assignment of home infusion benefits, and following all patient acceptance criteria policies and procedures
- Identifying participating payers and contractual pricing agreements
- Verifying health insurance coverage using verification forms
- Inquiring about case management, with authorization number and pre-certification
- Obtaining/maintaining authorization numbers
- Performing case management updates for changes in therapy and patient status
- Once verification is complete and admission criteria is reviewed/approved by clinical staff, contacting referral source to notify of acceptance or denial of referral
- When needed, coordinating the discharge plan with the referral source/discharge planner, nursing agency when applicable, pharmacy, and patient/caregiver
- Establishing relationships with licensed and certified nursing agencies to provide clinical nursing services to pharmacy patients
- Notifying patient or approved patient advocate and explaining their financial responsibilities
- Completing all applicable sections of Intake and Confirmation forms, and entering into CPR+
- Negotiating pricing with case management under the direct supervision of Center Manager
- Assisting with the creation and maintenance of Medicare CMNs
- Obtaining and tracking authorizations
- Completing monthly re-verification of Medicaid recipients
- Documenting credit and cash co-payments made at location level
- Obtaining clinical documentation necessary for billing
- Responsible for the intake of personal referrals
- Data-entry and updating patients' demographic information
- Insurance benefit verification and coordination with nursing and pharmacy staff
- Preparing and managing paperwork and documentation for billing and collections
- Resolving patient/payee issues in a timely manner