OptumRX / Briova is searching for individuals who have a drive to help patients and forward medicine through cutting edge outcomes technology and a patient-centric focus. In this role, you will need to be able to adjust to change and have excellent interpersonal and communication skills in order to succeed in our employee-focused company culture. Every employee is empowered to do whatever it takes to get the job done and at the center of our core values are our patients.
We have an outstanding opportunity to work for a fast-growing home infusion company, and are seeking a patient-focused Intake Coordinator with recent, successful experience in home infusion or related healthcare patient / customer service.
- Perform intake of initial patient referrals received including but not limited to collection and data entry of patient demographic information, medical information, therapy information, insurance/financial information.
- Coordinate and verify both major medical and pharmacy benefits with any and all payor types to include Medicare, Medicaid and Commercial payors.
- Obtain prior authorization or pre-certification of services to be rendered as required by each individual payor.
- Effectively communicate all intake and insurance verification information to patient and appropriate departments including Billing, Patient Services and Pharmacy.
- Answer incoming telephone calls and triage to appropriate personnel as indicated.
- Enter any additions or changes of information as applicable and take any action(s) required by these additions or changes.
- Complete and manage all paperwork or supportive documentation required for performing effective billing.
- Re-verify patient eligibility, monitor insurance lifetime caps and prior authorization periods.
- Resolve patient / payor issues in a timely manner.
- Participate in Departmental, Clinical and Company meetings as requested.
- Follow Current Referral Intake Process Flow.
- Participate in on-call rotation.
- High School Diploma / GED or higher
- 1+ years intake / insurance experience in home infusion or similar healthcare setting (doctor’s office, surgical center, hospital) including insurance verification, healthcare benefits assessment, paperwork and documentation for billing commercial insurances and Medicare / Medicaid or related experience.
- General Knowledge and understanding to obtain prior authorizations / pre-certification as required by insurance carriers.
- Knowledge of and the ability to maintain strict confidentiality of medical and administrative records adhering to the standards for health record-keeping under HIPAA and Privacy Act requirements.
- Associate’s degree or higher is preferred
- 3+ years home infusion experience is a plus
- Ability to work with and maintain good relationships with interdisciplinary team including, but not limited to: physicians, nurses, pharmacists, social workers, case managers, support staff, service providers, sales staff and patients.
- Exceptional communication, interpersonal, listening, organizational, problem solving and critical thinking skills.
- Demonstrated ability to communicate effectively both verbally and in writing.
- Ability to multi-task and prioritize in order to complete daily tasks with minimal supervision.
- Be a team player who thrives in a patient-focused environment.
OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do.
If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance. Join us and start doing your life’s best work.SM
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Keywords: Optum, Home Infusion, Intake, Intake Coordinator, Medicare, Medicaid, New Jersey, Pine Brook, NJ, Insurance Verification