Job Snapshot
Location:
Salem, OR 97914
Industry:
Healthcare - Health Services
Contact Information
Description
OptionCare, a wholly owned subsidiary of Walgreens specializes in providing comprehensive care to patients with acute and chronic conditions in their homes, ambulatory treatment centers and physician offices. Its services include intake coordination, benefits and reimbursement support, medication fulfillment and administration, compliance and patient education, one-on-one care and customer service. Skilled nurses and pharmacists are accessible 24/7 to deliver and manage complex infusion and injectable therapies from more than 100 OptionCare home infusion and specialty pharmacies in 35 states. OptionCare's services also include respiratory therapy and home medical equipment at some locations.
Job Duties Include:Â
Responsible for taking Durable Medical and Respiratory Therapy referrals from referral sources. Ensures that all intake forms are complete, clear and within Walgreens-OptionCare scope of service. Verifies insurance, enters patient demographics into the computer system, communicates with other departments regarding status of referrals and notifies patients / families regarding coverage and payment responsibilities.
Accepts in-coming Durable Medical and Respiratory Equipment referrals. Speaks in a professional manner to interal and external customers. Guides the referral sources through the intake process and provides other resources when Walgreens-OptionCare, for whatever reason, cannot perform the service. Offers alternatives, calls sub-contractors when necessary, and/or provides phone numbers to other providers.
Speaks knowledgeably of the scope of services that Walgreens-OptionCare can provide. Provides the referral source not only with the scope of Durable Medical and Respiratory services, but also various other programs offered by Walgreens-OptionCare.
Speaks knowledgeably regarding reimbursement issues and which insurance companies Walgreens-OptionCare has active contracts with. Is educated on the various payors Walgreens-OptionCare is contracted with, and whether certain services are covered or not at the time of the referral.
Is able to take complete, accurate intakes. All information on the intake sheet is completed consistently. Finds alternative resources when the referral source does not have certain information.
Completes, maintains and distributes the referral log. Completes referral logs in order for marketing and management to have an accurate picture of day to day referral patterns and trends.
Ensures that insurance verification is completed prior to giving the referral to a Delivery Driver, Reimbursement Specialist and / or Respiratory Therapist. Ensures that the intake is marked appropriately, such as STAT, next day, next week, etc. Follows up with insurance verification if the intake referral is not received back in the time specified. Obtains the initial authorization from the insurance company for the services to be provided.
Ensures that the Delivery Driver, Reimbursement Specialist and/or Respiratory Therapist receives the referral in a timely fashion. Makes sure that delivery drivers and/or respiratory therapist are kept well informed regarding possible new patients.
Assists the Delivery Drivers and/or Respiratory Therapist with any necessary sub-contracting of services. It may be necessary to cal other agencies to assist with providing equipment and other services not provided by Walgreens-OptionCare. The Intake Coordinator should be aware of which agencies Walgreens-OptionCare is contracted with. Assists the Delivery Driver and/or Respiratory Therapist with various tasks related to Case Management.
Requirements
- Excellent Medical Terminology skills
- Excellent written and verbal communication skills
- Ability to learn and understand reimbursement issues and Medicare guidelines
- 1-2 years' experience in a health care related field
- High School diploma with one year post high school education
Preferred Qualifications:
- 2 years' experience in Durable Medical Equipment
- Working knowledge of Medicare / Medicaid Durable Medical and Respiratory Equipment reimbursement guidelines
