Job Description
Position: Benefits Coordinator
Department: AIS Operations
Objective
The Benefits Coordinator ensures that insurance is active and authorization for service is on file prior to treatment.
Reporting Relationship
Infusion Services Lead
Scope of Supervision
N/A
Responsibilities
- Complete verifications for all patients in AIS queue, established and new patients.
- Initiate and follow-up on prior authorization/pre-determination for all patients in AIS queue.
- Calculate patient responsibility.
- Explain insurance benefit with the patient prior to treatment.
- Obtain any patient responsibility amount due before treatment.
- Align with Patient Assistance Coordinator to ensure that all patients are enrolled in Copay Assistance/Foundation programs if applicable.
- Complete weekly verification/pre-certification for established patients.
- Work with Nurse Liaison to identify issues with patients scheduled treatment.
- Escalate any insurance trends to Management.
- Timely response on all company communications.
- Report any misconduct, suspicious or unethical activities to the Compliance Officer.
- Participate in surveys conducted by authorized inspection agencies.
- Participate in the pharmacy’s Performance Improvement program as requested by the Performance Improvement Coordinator.
- Participate in pharmacy committees when requested.
- Participate in in-service education programs provided by the pharmacy.
- Perform other duties as assigned by supervisor.
Minimum Qualifications
- High School Diploma.
- Two years of experience in the healthcare field.
- Knowledge of PPO, HMO and Medicare insurances.
- Ability to evaluate options and to make efficient decisions.
- Organizational skills sufficient to maintain consistently accurate records.
- Computer skills that include proficiency with spreadsheets and use of the internet, as well as word processing, and efficient use of the internet and e-mail.
Physical RequirementsThe physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions in this job description:
- The employee is regularly required to stand, walk, and sit, as well as talk and hear.
- The employee is required to use hands to operate office equipment.
- The employee must occasionally lift and/or move up to 20 pounds.
- Specific vision abilities required by this job include close vision, distance vision, peripheral vision, and the ability to adjust focus.I understand and agree to comply with this job description:
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Weekly day range:
Experience:
- Microsoft Office: 2 years (Preferred)
- PPO, HMO and Medicare insurance: 2 years (Preferred)
- Medical benefits verification: 2 years (Preferred)
Work Location: Hybrid remote in Houston, TX 77074