Intake Specialist II – Healthcare

Description Who We Are TwelveStone Health Partners is focused on the medication needs of patients with chronic, complex and rare conditions. For more than 35 years, TwelveStone Health has been dedicated to finding new ways to deliver care designed around the patient. Chronic conditions include Multiple Sclerosis, NMOSD, Myasthenia Gravis, CIDP, ITP, Migraine Prevention, Crohn’s Disease, Ulcerative Colitis, Plaque Psoriasis, Alpha 1 Antitrypsin Deficiency, Primary Immunodeficiency, hATTR Amyloidosis, Thyroid Eye Disease, and many others. For patients, we provide access to the most advanced medications, along with the personal and financial support patients need to live with chronic conditions. For providers, we simplify treatment for complex conditions by eliminating the administrative and clinical burdens placed on your practice when patients need innovative specialty medications. TwelveStone Health Partners supports the transition from acute to post-acute care environments and the journey from sickness to health. We are currently licensed in 50 states.

Summary

We currently have an opening for our Intake Specialist II position in the Murfreesboro area. This position collaborates with various referral sources and other departments on initial patient admissions. Obtains information and documentation to process referrals and meet insurance requirements for successful authorizing, dispensing and billing of patient’s medications and care. Communicates with patients on referral process, expenses and patient questions. Understands and reviews medical policies specific to Insurance/Policies, understands and reviews contracting for insurances. Essential Duties & Responsibilities

• Manage email, fax and web portals for new referrals, answer incoming calls regarding referrals and work closely with other departments to complete referrals. Verify insurance coverage to determine patient OOP, obtain documentation to ensure the product(s) are being ordered meet(s) insurance requirements, coordinate with authorization counterparts to ensure all information required by insurance is successfully authorized, dispense and bill medication. Capture all relevant information in internal systems.
• Arrange nursing as needed for patients with a variety of nursing agencies, based on insurance and patient need and assist in negotiating nursing rates with nursing agencies if subcontracting is needed due to insurance company requirements.
• Other duties as assigned.

Requirements

Education: High School Diploma or GED required. Current, unrestricted Pharmacy Technician (PT) license in the state of practice and Pharmacy Technician certification (CPhT) or professional license (LPN, Medical Assistant, etc.) preferred. Experience: One to two years of related intake or medical office experience required. IV/Specialty Pharmacy Experience (preferred). Knowledge of HCPC coding, medical/pharmacy terminology and ICD-10 codes preferred. Medical ERM and/or other medical software knowledge required. Functional Competencies: Attention to detail, critical thinking, problem solving, approachable, phone etiquette, dependable, verbal and written communication, teamwork, cooperation, collaboration.