Lead Intake & Insurance Verification Coordinator

📋 Description

• Gather and confirm comprehensive insurance details, including the prior authorization process, copay assistance, and coordination of benefits.

• Assist in managing the workload to ensure that referrals and orders are processed promptly.

• Oversee each queue through various reports and redistribute tasks as necessary.

• Act as the main point of contact for key physicians’ offices and coordinate referrals with the sales team during the insurance verification process.

• Serve as the designated representative for contracted payors.

• Act as the designated representative for special pharmaceutical accounts, collaborating with their HUBs and collecting and documenting pharma-specific data in the system.

• Obtain and confirm insurance eligibility for provided services and document complete information in the system.

• Conduct prior authorizations as required by the payor source, including gathering necessary documentation by collaborating with physician offices and insurance companies.

• Collect clinical information such as lab results, diagnosis codes, etc.

• Determine the patient's financial responsibilities as outlined by the insurance.

• Configure coordination of benefits information for every referral.

• Ensure that assignment of benefits is obtained and maintained for Medicare claims.

• Bill insurance companies for the therapies rendered.

• Document all relevant communication with patients, physicians, and insurance companies as it relates to collection procedures.

• Identify and coordinate patient resources related to reimbursement, including copay cards, third-party assistance programs, and manufacturer assistance programs.

• Manage inbound calls from patients, physician offices, and/or insurance companies.

• Perform other duties as assigned.

• Adhere to all policies and standards.

⛳️ Requirements

• High school diploma or equivalent.

• Minimum of 3 years of experience in medical billing, insurance verification, call center operations, and/or previous experience as a lead managing cross-functional teams.

• Familiarity with payors and prior authorization requirements.

🏝️ Benefits

• Competitive pay.

• Health insurance.

• 401K and stock purchase plans.

• Tuition reimbursement.

• Paid time off plus holidays.

• Flexible work approach with options for remote, hybrid, field, or office schedules.