Summary: The position of Intake Referral Coodinator assists the Admissions Team Lead with services and all issues related to referral procesing. The Intake Referral Coodinator is responsible for the accurate and complete processing (benefit verification through clearance) of speciality pharmacy and infusion therapy referrals from referral sources.
Education/Experience: High school diploma or GED required. Six months of relevant experience in the healthcare industry required. Specialty Infusion experienced preferred.
Certificates and Licenses:
Valid license, registration and/or certification, in good standing, to practice as a Pharmacy Technician as required by the Board of Pharmacy in the state employed preferred.
Duties and Responsibilities include the following. Other duties may be assigned.
Ensure that all referrals are complete, clear and within DSIG’s scope of service.
Verify insurance accurately and completely prior to passing the referral to the pharmacy staff.
Gather and exchange information to gain authorization for therapy requested and re-authorization as necessary which may include gathering patient-specific clinical data from referral sources
Coordinate with Sales and Advocates in order to facilitate records requests from referral sources.
Request and perform timely follow-up on authorizations for medical and pharmacy benefits
Calculate gross margins for therapies
Enter patient demographic information into the clinical system.
Communicate with other departments, including sales, regarding the status of referrals and documnentation requests.
Notify patients/families/referral sources regarding coverage and payment responsibilities as necessary.
Speak knowledgeably regarding reimbursement issues and which insurance companies DSIG has active contracts with.
Respond to inquiries from patients and referral sources via telephone, fax and electronic data interfaces.
Document in the patient’s clinical record progress notes, all requests and conversations for the purposes of seamless coordination of care.
Demonstrate professional etiquette and courtesy when interfacing with consumers/ customers.
Aid in the resolution of consumer/customer complaints by identifying problems and coordinating appropriate corrective action through attention to detail and taking the initiative to resolve issues before they become a problem.
Comply with and adheres to all regulatory compliance areas, policies and procedures and company “best practices”.
Insure that the patient database is complete for height, weight, current and past medical history, clinical laboratory results and concurrent medications (including over-the-counter and/or home remedy medications) as necessary.
Assist the pharmacist, nurse and patient with clinical and technical support.
Work with team of other pharmacists, pharmacy technicians, nurse manager and sales staff to ensure quality of care to all patients.
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