Intake Authorization Specialist

Company: TwelveStone Health Partners
Location: Murfreesboro
Posted on: March 16, 2023

Job 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, Cystic Fibrosis, Hemophilia, Crohns Disease, Growth Deficiency, HIV, Leukemia, 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.

Providers we serve: Hospitals, Long-Term Care Facilities, Hospice, Home Care, Specialty Clinics Solutions include: MEDIpack packaged medications, nutrition therapy, home infusion services, specialty pharmacy services, and infusion centers.

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.

This position currently falls under the Centers for Medicare and Medicare Services (CMS) vaccine mandate. If you are selected for this position, you will be required to comply with CMS requirements. A reasonable accommodation process is available for new hires through our Human Resources department.

This position is responsible for obtaining prior authorizations for patients before prescriptions are filled and dispensed.

Essential Duties & Responsibilities

* Collect and analyze information needed (demographic, and clinical information) to provide or deny pre-authorizations and authorizations. Input appropriate data into appropriate database, including patient demographics, insurance carrier information and other essential admission information for authorization to ensure accurate billing, reporting, and analysis can be performed by facility, corporate, state and federal agencies. Provide explanation of intake documents in accordance with regulatory requirements.
* Supports continuous improvement activities. Maintains and protects confidential information and provides excellent customer/patient services.
* Other duties as assigned.

Minimum Qualifications:

Education: High School Diploma or GED required. Associates degree in medical billing or another related field preferred. Current, unrestricted Pharmacy Technician license in the state of practice and Pharmacy Technician certification preferred.

Experience: Two years experience medical claims billing or authorization/processing required. Knowledge and understanding of Medical Terminology and Medicare Compliance, HIPPA regulations, DRGs, ICD10 codes, and HCPC codes, as well as insurance and reimbursement processes, 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, judgment, initiative, follow-through.

Keywords: TwelveStone Health Partners, Murfreesboro , Intake Authorization Specialist, Other , Murfreesboro, Tennessee