Location: 7039 Valjean Ave, Van Nuys, CA 91406
Schedule: Monday-Friday 9-6pm
Job Summary:
Responsible for performing the appropriate procedures to verify patient eligibility, coordinate benefits, run test claims, submit initial authorization and determine patient coverage/responsibility for services
Job Description:
Job Responsibilities
- Performs Insurance Verification of benefit coverage on all of patient's insurance plans for each service being provided.
- Obtains and documents in the system all information related to coinsurance, copay, deductibles, authorization requirements, etc.
- Creates documentation required to service the patient per policy and payer guidelines.
- Determines estimated patient financial responsibility using insurance verification information and payer contracts and/or self-pay guidelines.
- Obtains initial authorization prior to admitting the patient for all services for any insurance plan that has authorization requirements.
- Obtains reauthorization as necessary, reviews physician orders from pharmacy to determine if authorization is required on changes / additions to therapy for patients that are already on service.
- Does this position have supervisory responsibilities? No
Basic Education and/or Experience Requirements
- Current CA pharmacy technician license required
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Basic Qualifications*
- Experience establishing and maintaining relationships with individuals at all levels of the organization.
- Experience providing customer service to internal and external customers, including meeting quality standards of services and evaluation of customer satisfaction.
- Basic PC skills including email, Microsoft Word, Excel and PowerPoint.
- Typing skills ~40 words per minute
- Experience in identifying operational issues and recommending process improvements.
- Strong communication skills to speak with external service providers and internally with the AleraCare team to coordinate services.
- Strong organizational skills.
Preferred Qualifications
- Prior experience in home infusion intake/specialty intake coordination
- Previous Infusion Medical Billing/Collections or Intake/Admissions Experience.