Key Accountabilities:

  • Facilitate patient onboarding for infusion center services, ensuring all demographic, clinical, and insurance details are collected accurately.

  • Verify insurance coverage, including understanding Medicare Part B, in-network and out-of-network benefits, and patient financial responsibilities.

  • Perform benefit investigations and manage prior authorization requirements for infusion therapies.

  • Communicate with Medical Doctor Offices (MDOs) and insurance companies to obtain missing information or coordinate coverage as needed.

  • Gather and maintain required documentation for prior authorizations and billing purposes.

  • Complete status checks with insurance companies regarding approvals or denials and escalate issues that may delay patient treatment.

  • Build and maintain effective relationships with prescribers, MDOs, and internal staff to provide timely and accurate patient-specific information.

  • Accurately enter patient and insurance information into the electronic medical record (EMR) system and maintain up-to-date records.

  • Coordinate infusion appointment scheduling.

  • Scan, fax, or upload required clinical and insurance documents to MDOs, insurance providers, or internal systems.

  •  Ensure compliance with all organizational and regulatory standards while providing high-quality patient service.

  • Assist walk-in patients with scheduling, insurance questions, or documentation needs as necessary.       

 

Experience:

  • Proven experience in a healthcare setting such as a doctor’s office, focusing on patient access, insurance verification, or administrative coordination.
  • Strong understanding of insurance verification, prior authorizations, and benefit investigation processes.
  • Familiarity with Medicare Part B, medical coverage, and patient financial responsibilities.
  • Knowledge of in-network vs. out-of-network benefits.
  • Excellent data entry skills and attention to detail.
  • Strong communication and interpersonal skills.
  • Ability to work collaboratively in a fast-paced healthcare environment.

 

Preferred Qualifications include:

  • Experience in infusion center or specialty therapy settings.
  • Familiarity with medical billing codes and documentation requirements for infusion therapies.
  • Experience assisting patients with financial assistance programs or patient support services.

 

Behavioral competencies: 

  • Excellent verbal and written communication skills. 
  • Excellent interpersonal, negotiation, and conflict resolution skills.
  • Excellent organizational skills and attention to detail.
  • Strong analytical and problem-solving skills.
  • Ability to prioritize tasks and to delegate them when appropriate.
  • Ability to act with integrity, professionalism, and confidentiality.