Reimbursement Specialty Liaison - Remote - Columbia
Option Care Health
**Extraordinary Careers. Endless Possibilities.**
**With the nation’s largest home infusion provider, there is no limit to the growth of your career.**
Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and team members.
Join a company that is taking action to develop an inclusive, respectful, engaging and rewarding culture for all team members. At Option Care Health your voice is heard, your work is valued, and you’re empowered to grow. Cultivating a team with a variety of talents, backgrounds and perspectives makes us stronger, innovative, and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare.
**Job Description Summary:**
Responsible for new patient referral and intake duties, case management, scheduling, patient account management, billing and accounts receivables (AR) activities for patients utilizing the pharmacy based contracts. Be actively involved with the Reimbursement & IMC Teams, to bridge the gap between Intramed Plus and the IMC.
**Job Description:**
+ Serves as a liaison between pharmacy and infusion center to expedite the processing and coordination of new referrals.
+ Work with physician offices to obtain needed clinical information to assess reimbursement criteria for specialty infusions.
+ Investigates type of insurance coverage and verifies accuracy of information, including that the diagnosis meets the needs for the drug therapy ordered by physician.
+ Effectively complete and manage the case management authorizations, to include authorization appeals.
+ Serves as a patient advocate, working closely with patients to provide reimbursement support through grants, copay assistance, payment plans, etc.
+ Ensures that patient is knowledgeable of out of pocket cost prior to infusion date and updates billing alerts to reflect amount being collected at time of the infusion.
+ Ensures compliance with policies and guidelines outlined in the contract terms and fee schedule. Follows HIPPA guidelines when accessing and sharing patient information to maintain patient and business confidentiality.
Supervisory Responsibilities: i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.
No
Basic Education and/or Experience Requirements:
+ High School Diploma or equivalent
+ Minimum 1 year of healthcare intake/admission and/or reimbursement experience
+ Demonstrated leadership and complex problem-solving capabilities
Basic Qualifications & Interests:
+ Experience in identifying operational issues and recommending and implementing strategies to resolve problems.
+ Intermediate level skill in Microsoft Excel (for example: using SUM function, setting borders, setting column width, inserting charts, using text wrap, sorting, setting headers and footers and/or print scaling).
+ Basic level skill in Microsoft Word (for example: opening a document, cutting, pasting and aligning text, selecting font type and size, changing margins and column width, sorting, inserting bullets, pictures and dates, using find and replace, undo, spell check, track changes, review pane and/or print functions).
Preferred Qualifications & Interests:
+ Certified Professional Coder (CPC) from AAPC or AHIMA
Due to state pay transparency laws, the full range for the position is below:
Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.
Pay Range is $17.24-$28.72
**Benefits:**
-Medical, Dental, & Vision Insurance
-Paid Time off
-Bonding Time Off
-401K Retirement Savings Plan with Company Match
-HSA Company Match
-Flexible Spending Accounts
-Tuition Reimbursement
-myFlexPay
-Family Support
-Mental Health Services
-Company Paid Life Insurance
-Award/Recognition Programs
_Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information._
For over 40 years, Option Care Health has provided adult and pediatric patients with an alternative to hospital infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality infusion services for nearly all patients with acute and chronic conditions across the United States, resulting in high quality outcomes at a significantly reduced cost. Option Care Health has more than 70 infusion pharmacies and 100 alternate treatment sites. We are guided by our purpose to provide extraordinary care that changes lives through a comprehensive approach to care along every step of the infusion therapy process including: intake coordination, insurance authorization, resources for financial assistance, education and customized treatments.
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