Infusion Intake Specialist

Washington Gastroenterology believes that digestive health is the foundation for a healthy life. We are committed to improving the quality of life and longevity of our patients and our communities through the prevention, detection, and treatment of gastrointestinal diseases.

We are WAGI

WAGI is seeking a Full-timeInfusion Intake Specialistto join our Revenue Cycle Team. The Infusion Intake Specialist is responsible for verifying patient benefits and insurance information prior to their scheduled infusion or injection. Ensures needed authorizations have been obtained and are in place at the time of service. In addition, obtains specialty injection medication authorizations for IBD patients as prescribed by the providers of Washington Gastroenterology.

This team primarily works remotely from home supporting our clinics and endoscopy centers (must be Washington based, see specifics below).

Responsibilities

• Reviews upcoming appointment schedule to verify valid insurance and eligibility is present for each infusion visit or ordered IBD medication. This is accomplished via gMed, internet based systems, insurance websites, or telephone inquiries with the payer.
• Obtains authorizations for IBD medications as prescribed by the ordering providers of Washington Gastroenterology to include specialty pharmacy requests.
• Acts as a patient advocate or liaison. Contacts patient, other providers or insurance companies for updated insurance information as needed.
• Appropriately counsels patients regarding copay assistance programs and collection policies.
• Researches patients’ insurance benefits for authorization/referrals required. Submits requests and monitors to ensure these are in place prior to the date of service.
• Verifies if medications are eligible for buy and bill vs specialty pharmacy and communicates this information to infusion staff.
• Accurately documents patient accounts to reflect all actions taken, or status of eligibility/authorizations in billing system.
• Verifies eligibility for all Medicaid patients at the first of every month.
• Handles gMessages, tasks, and emails in a timely and appropriate manner.
• Calculates patient out of pocket for infusions and IBD medications, and notifies patient and assists with copay assistance program enrollment as needed.
• Alerts point person on infusion staff when a patient is not responding to collection efforts.
• Verifies an office visit is scheduled prior to an expiring authorization.
• Ensures labs ordered are completed (i.e., TB Quant, Hepatitis Panel, and CXR).
• Tracks and maintains records for pending and upcoming refill authorizations.
• Responds to inquiries from staff, physicians, patients and referring provider offices in a professional and caring manner.
• Establishes and maintains a professional and collaborative relationship with all staff in order to resolve problems and increase knowledge of insurance requirements and prevent delays in patient care.
• Reports changing insurance requirements to leadership.
• Identifies and reports compliance concerns to avoid fraudulent billing.
• Performs other duties as assigned.

Qualifications

• High School graduate or GED required
• 2 years of experience working with prior authorizations in a medical practice or healthcare system required
• 1 year experience working with infusion services preferred

Skills and Abilities

• Ability to work independently with minimal supervision
• Basic math skills
• Strong analytical and problem-solving skills
• Ability to follow oral and written instructions required
• Ability to make critical decisions while following company procedures is required
• Ability to read and process provider orders required
• Ability to prioritize tasks and to delegate them when appropriate
• Proficient in Microsoft Office products, specifically Excel and Word
• Ability to multitask in a fast paced environment
• Ability to work effectively with co-workers as a team member is required

Physical Activities and Requirements

• Prolonged periods of sitting/stationary work and performing administrative duties including the use of computers and phones
• Ability to bend, twist, stoop, and reach, rarely
• Able to lift and carry supplies and equipment as needed (up to 25 pounds)

This team primarily works remotely from home with training conducted onsite in Tacoma, WA. Candidates must reside and work in Washington State and due to unique city ordinances that impact employers, WAGI does not allow anyone to work remotely from Seattle, WA. The following conditions must be met for interested candidates in their remote location:

• Minimum internet connection requirements and surge protection in your home
• A home work environment that allows you to work free from distractions and sources of background noise and free of potential hazards including tripping hazards, electrical hazards, etc.
• Ability to secure and protect WAGI supplied computer, phone, and systems and ensure protection of Personal Health Information (PHI)
• Though this position provides the benefit of telework, it does follow a standard schedule based on the hours of operation

Washington Gastroenterology has an excellent compensation and benefit package that includes the following:

Employees (and their families) who work full time (defined as working 30 or more hours per week) will be eligible for medical, dental, vision, long-term disability, accidental death and dismemberment, and basic life insurance. In addition employees are able to enroll in our company’s 401(k) plan which includes a company provided safe harbor contribution of 3% of annual earnings and the potential for a company discretionary profit sharing contribution.

All employees will be eligible to accrue PTO at a rate of .04 hours per payroll hour (1.6 hours for a 40 hour week) which can be used for and exceeds the required mandatory WA State and other local ordinances. In addition, full time employees will be eligible for a Vacation accrual with a maximum annual accrual of 77 hours as a new hire.

WAGI has 8 standard Holidays each year for which full time employees are eligible to receive paid holiday. In addition, full time employees will be given 1 Float Holiday each year that they can schedule.

This is an Hourly position and the anticipated Compensation range is $22.10 - $28.60. The hired applicant is also eligible for annual discretionary bonuses.