McKesson Senior Intake Specialist in Houston, Texas
McKesson is in the business of better health and we touch the lives of patients in virtually every aspect of healthcare. At McKesson Specialty Health, our products and services span the full continuum of specialty patient care. From the initial phases of a product life cycle and the distribution of specialty drugs, to fully integrated healthcare technology systems, practice management support, and ultimately to patient care in the communities where they live, we empower the community patient care delivery system by helping community practices advance the science, technology and quality of care.
We have a vision —that the long-term vibrancy of community care will be achieved through the leadership of physicians committed to clinical excellence and innovation, enabled by close collaboration with our organization and our deep clinical, operational and technological expertise.Every single McKesson employee contributes to our mission—by joining McKesson Specialty Health you act as a catalyst in a chain of events that helps millions of people all over the globe. You’ll collaborate on the products and solutions that help us carry out our mission to improve lives and advance healthcare. Working here is your opportunity to shape an industry that’s vital to us all.
Join our team of leaders to begin a rewarding career.
Intake Specialist will be responsible for maintaining effective communication between infusion site nurses, sales team, insurance agents and practice organizations. Qualified candidates must have excellent written and verbal communication skills, advanced computer literacy and the ability to multi-task in a fast-paced work environment. Under the direction of the Patient Access Manager, candidates will be responsible for determining eligibility for new and existing infusion therapy patients via verification of insurance benefits, review of policy guidelines for coverage criteria and attainment of initial referral if required. Additionally, understanding of when pre-certifications, pre-determinations and prior authorizations are necessary as well as how to initiate processing of each is required. Ability to evaluate profitability of infusion therapies and communicate issues is necessary.
ESSENTIALFUNCTIONS AND DUTIES
Verifies insurance benefits for new patient referrals.
Re-verifies insurance benefits for existing patients.
Accurately evaluates charge and reimbursement estimatesfor infusion therapies.
Reviews all medical documentation against medicalpolicy and initiates pre-determination, pre-certification, andauthorizations as needed.
Follow-up on pending pre-certifications and/orpre-determinations until outcome decided.
Updates and maintains insurance and authorizationinformation in billing software.
Obtains PCP referrals as needed.
Maintains high profile site assignments and operationalneeds daily.
Departmental training integrator for Intake Team.
Complete special projects as assigned by Patient AccessManager.
Performs other job related duties as assigned.
2 years experience within a healthcare environment
Minimum of 1 year knowledge of insurance benefits which includes, deductibles, co-insurance, out-of-pocket, plan exclusions and prior authorization requirements; preferably in an infusion therapy setting
Two or more years of intake/patient access experience in healthcare industry preferred
Medical claims experience preferred
Must be able to communicate effectively, both orally and in writing.
Must demonstrate an understanding of reimbursement practices including government program regulation and managed care contracting.
Must demonstrate adaptability to handle changing priorities in a high volume, fast-paced work environment.
Must demonstrate exceptional organizational skills and ensure attention to detail at all times.
Excellent personal computing skills and a working knowledge of MS Office software.
Maintains clear communication with customers regarding mutual expectations. Takes personal responsibility and accountability for correcting customer-service problems
Must demonstrate ability to work well in a team dynamic as well as independently.
Additional Knowledge & Skills
Knowledge of insurance company practices regarding reimbursement. Understanding of CPT and ICD codes. Strong verbal and written skills in order to effectively communicate with co-workers, insurance carriers, patients and medical office personnel.
High School diploma or equivalent
General Office Demands
Benefits & Company Statement
McKesson believes superior performance – individual and team – that helps us drive innovations and solutions to promote better health should be recognized and rewarded. We provide a competitive compensation program to attract, retain and motivate a high-performance workforce, and it’s flexible enough to meet the different needs of our diverse employee population.
We are in the business of better health and we touch the lives of patients in virtually every aspect of healthcare. We partner with payers, hospitals, physician offices, pharmacies, pharmaceutical companies and others across the spectrum of care to build healthier organizations that deliver better care to patients in every setting.
But we can’t do it without you. Every single McKesson employee contributes to our mission—whatever your title, whatever your role, you act as a catalyst in a chain of events that helps millions of people all over the globe. Talented, compassionate people are the future of our company—and of healthcare. At McKesson, you’ll collaborate on the products and solutions that help us carry out our mission to improve lives and advance healthcare. Working here is your opportunity to shape an industry that’s vital to us all.
McKesson is an equal opportunity and affirmative action employer – minorities/females/veterans/persons with disabilities.
Qualified applicants will not be disqualified from consideration for employment based upon criminal history.
No agencies please.
Organization: McKesson Specialty Health
Title: Senior Intake Specialist
Requisition ID: 18001325