INTRODUCTION

Company Overview:

BioMatrix is a nationwide, independently-owned infusion pharmacy with decades of experience supporting patients on specialty medications. Our compassionate care team helps patients navigate the often-challenging healthcare environment. We treat our patients like family and get them started on therapy quickly. We work closely with them as well as their family and their healthcare providers throughout the patient journey, staying focused on optimal clinical outcomes.

At BioMatrix the heart of our Inclusion, Diversity, Equity, & Access (IDEA) philosophy is the commitment to cultivate a welcoming space where everyone's contributions are acknowledged and celebrated. Our goal is to draw in, develop, engage, and retain talented, high-performing individuals from diverse backgrounds and viewpoints. We believe that both respecting and embracing diversity enriches the experiences and successes of our patients, employees, and partners.

Schedule:

It is anticipated that an incumbent in this role will work Monday through Friday between 8:30am and 5pm Central Standard Time. Schedule subject to occasional change based on business needs.

Location:

It is anticipated that an incumbent in this role will work on-site at our location in Overland Park, KS. Work location subject to change based on business needs.

Job Description:

The Intake Specialist is responsible for ensuring the intake/prior authorization processes and workflows are performed optimally and effectively. Work with manager to meet the needs of the department to secure contracts, authorizations and maximize reimbursement coverage.

QUALIFICATION REQUIREMENTS

• High School Diploma or GED required
• Minimum of two (2) years of care coordination or patient services experience, to include medical insurance experience, required
• Basic computer and internet skills (e.g. Microsoft Office)
• Ability to obtain reimbursement and prior authorizations for patients, family members, caregivers, nurses, physicians, and health plan representatives and/or administrators.
• Commitment to excellent customer service and professionalism to resolve complex payer coverage issues

QUALIFICATIONS PREFERRED

• Certified Pharmacy Technician/License preferred
• Prior home infusion experience preferred
• Prior patient financial assistance experience preferred
• Prior CareTend experience preferred

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

• Maintains day-to-day patient authorization and reimbursement activities, workload and overall workflow
• Maintains strict confidentiality of patient, visitor, and employee information. Complies with HIPAA Privacy Rule standards.
• Receives patient referrals and works on the patient's behalf to identify and assess reimbursement coverage options for those with insurance and to coordinate and/or investigate financial options for those without insurance.
• Obtains and monitors prior authorization process to ensure optimal and effective workflow.
• Reports denials or non-eligible patients to the contracts department to identify and secure contractual opportunities.
• Works with physician offices and the pharmacy department to facilitate the process of obtaining prior authorization from third party payers in order to maximize patients' access to treatment.
• Communicates effectively with sales team and Regional Care Coordinators.

• Monitors and verifies benefits, records all insurance re-authorizations required by payers to help ensure compliance and continuity of treatment monthly.

• Contributes to effective operation of the pharmacy department.

• Collaborates with the billing team to maintain database for recording, managing, and monitoring patient insurance activities.

• Screens incoming orders, notifies pharmacy of insurance eligibility issues, and STAT orders to make same-day deliveries when requested.

• Participation in QMC Quarterly Meetings, as needed.
• Participates in orientation, education, training programs, CE's, literature reviews and other materials, as assigned.
• Completes all competence/skills billing assessments as required.
• Provides courteous, cooperative and timely service to patients, visitors, and staff.
• Participates in quality assurance activities and audits, as directed.

KNOWLEDEGE, SKILLS AND ABILITIES REQUIREMENTS

• Ability to maintain competence for current position.
• Ability to maintain accurate records and prepare reports and correspondence related to the work.
• Ability to perform work within specified time frames and adapt positively to frequent interruptions and changes in workload and/or work schedule.
• Strong customer service skills, focus and dedication.
• Excellent interpersonal and organizational skills.
• Ability to set priorities and solve problems.

• Excellent verbal, written, and communication skills.
• Ability to respond quickly to emergency requests.
• Self-motivated, self-reliant and team oriented.

Communication Skills

• Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; responds well to questions; demonstrates group presentation skills; participates in meetings.
  • Written Communication - Writes clearly and informatively; edits work for spelling and grammar; varies writing style to meet needs; presents numerical data effectively; able to read and interpret written information.

Computer Skills

• Become and remain proficient in all programs necessary for execution of the position.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

• This position requires constant sitting with occasional walking, standing, kneeling or stooping.
• This position requires the use of hands to finger, handle or feel objects and the ability to reach with hands and arms.
• This position requires constant talking and hearing.
• Specific vision abilities required by this job include close vision and the ability to adjust focus.
• This position must occasionally lift and/or move up to 20 pounds

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. If needing a reasonable accommodation within the application process, please contact the BioMatrix People & Culture team at [email protected] or 954.385.7322 x 1425.

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs;

balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally

lift and/or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

OTHER

• Will participate in legal and ethical compliance training each year.
• Will consistently behave in compliance with the BioMatrix, LLC's legal and ethical policies and procedures.
• Will abide by the policies of BioMatrix, LLC as set forth in the Compliance Manual.
• Will not participate in any conduct considered to be unethical or illegal.

EXPECTATION FOR ALL EMPLOYEES

Supports the organization's mission, vision, and values by exhibiting the following behaviors: integrity, dedication, compassion, enrichment and enthusiasm, places patients first, is all-in with stacked-hands, and is focused on relentless consistency wins.

GENERAL INFORMATION:

The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required of personnel so classified.

The incumbent must be able to work in a fast-paced environment with demonstrated ability to juggle and prioritize multiple, competing tasks and demands and to seek supervisory assistance as appropriate.

Incumbents within this position may be required to assist or find appropriate assistance to make accommodations for disabled individuals in order to ensure access to the organization's services (may include: visitors, patients, employees, or others).

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.