Extraordinary Care. Extraordinary Careers.
With the nation’s largest home infusion provider, there is no limit to the growth of your career.
Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 6,000 team members including 2,900 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and employees.
At Option Care Health we recognize that part of being extraordinary is supporting and building a workforce that is as diverse as the patients and communities we serve.
Join a company that is taking action to develop a culture that is more inclusive, respectful, engaging and rewarding for all team members. We are committed to hiring, developing, and retaining a diverse workforce.
Job Description Summary:
This position is responsible for processing all new patient referrals, managing current patient base and providing support to the Supervisor or Manager, Patient Onboarding. The main objective is to clear all patients prior to service in order to ensure proper payment in compliance within all legal and regulatory parameters, in cooperation with all other branch departments, and as an efficient and profitable business center.
- Evaluates referrals based on established company guidelines and/or parameters.
- Complies with reimbursement for products and services in compliance with Company policy and goals, to include drug, supply, and equipment selection and utilization, and participates in the submission of clean claims through compliance to proper pharmacy billing procedures.
- Communicates with various payors, referral sources, patients and sales representatives.
- Verifies eligibility and benefits accurately and in a timely manner in accordance with Company policies.
- Obtains initial authorizations following Company policy and maintains authorizations extension for all patients as appropriate.
- Processes all required paperwork according to established procedures. Ensures all documentation needed for billing is collected prior to or soon after accepting the referral.
- Answers telephone calls and emails in a professional and timely manner.
- Attends all required in services throughout the year.
- Performs other duties as assigned.
Does this position have supervisory responsibilities? No.
(i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.)
BASIC EDUCATION AND/OR EXPERIENCE:
- High school diploma or equivalent is required.
- Experiential requirements may be waived in lieu of evidence of progressive growth in and attainment of the skills necessary to perform the required duties.
- Knowledge of HCPC Codes and ICD-10 Codes and maintains up to date professional knowledge of Medicare, Medicaid and the insurance industry requirements for qualifying services.
- Knowledge of computerized information systems, including financial applications.
- Knowledge of infusion pharmacy durable medical and respiratory equipment reimbursement for state, federal and commercial payors.
- Ability to develop and maintain recordkeeping systems and procedures.
- Knowledge of the computer and its capabilities.
- Working knowledge of medical terminology.
- Ability to complete multiple projects with time sensitive deadlines.
- Ability to manage more than one priority project at a time.
- Ability to exercise independent judgment and at times work independently.
Language Skills Ability to read, analyze and interpret information appropriate to duties and responsibilities assigned. Ability to operate information systems, follow policy, complete required forms, and prepare reports. Ability to effectively present information and respond to questions from referral sources, managers, patients, employees, payors and the general public.
Mathematical Skills Ability to calculate and perform basic mathematical calculations such as pharmaceutical calculations, discounts, percentages, and volume.
Reasoning Ability Ability to define problems, collect data, establish facts, and draw valid conclusions.
This role does not have any travel requirements.
- College degree preferred.
- Minimum of three (3) years’ experience with medical insurance authorization in infusion services or other healthcare profession preferred.
- Minimum of one year customer service preferred.
- Home infusion experience on the provider or payor side preferred.
Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information.
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