Address
Form of workJob 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)
Dental insurance
Health insurance
Paid time off
Vision insurance
Schedule:
Monday to Friday
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
