Patient Records Coordinator

Cromwell, Connecticut


Extraordinary Care. Extraordinary Careers.

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 6,000 team members including 2,900 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 employees.

Job Description Summary:

This position is responsible for processing all new patient referrals, managing current patient base and providing support to the Intake/ Authorization Manager. The main objective is to clear all patients prior to service in order to ensure proper payment in compliance within all legal and regulatory parameters, in cooperation with all other branch departments, and as an efficient and profitable business center.

Job Description:

JOB RESPONSIBILITIES:

  • Evaluates referrals against branch service model parameters.
  • Complies with reimbursement for products and services in compliance with Company policy and goals, to include drug, supply, and equipment selection and utilization, and participates in the submission of clean claims through compliance to proper pharmacy billing procedures.
  • Communicates with various payors, referral sources, patients and sales representatives.
  • Verifies eligibility and benefits accurately and in a timely manner in accordance with Company policies.
  • Obtains initial authorizations following Company policy and maintains authorizations extension for all patients as appropriate. May obtain written prescription orders from physicians.
  • Processes all required paperwork according to established procedures. Ensures all documentation needed for billing is collected prior to or soon after accepting the referral.
  • Attends all required in services throughout the year.
  • Performs other duties as assigned.

SUPERVISORY RESPONSIBILITIES:

Does this position have supervisory responsibilities? No.

(i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.)

BASIC EDUCATION AND/OR REQUIREMENTS:

  • High school diploma or equivalent is required.
  • Experiential requirements may be waived in lieu of evidence of progressive growth in and attainment of the skills necessary to perform the required duties.

BASIC QUALIFICATIONS:

  • Knowledge of HCPC Codes and ICD-9 Codes and maintains up to date professional knowledge of Medicare, Medicaid and the insurance industry requirements for qualifying services.
  • Strong interpersonal and communication skills and the ability to work effectively with branch departments.
  • Knowledge of computerized information systems, including financial applications.
  • Knowledge of infusion pharmacy, durable medical and respiratory equipment reimbursement for state, federal and commercial payors.
  • Basic pharmacy knowledge of reading and interpreting prescriptions.
  • Ability to develop and maintain recordkeeping systems and procedures.
  • Working knowledge of medical terminology.
  • Demonstrated knowledge and proficiency in the principles, procedures and best practices related to this position.
  • Language Skills
  • Ability to read, analyze and interpret information appropriate to duties and responsibilities assigned. Ability to operate information systems, follow policy, complete required forms, and prepare reports. Ability to effectively present information and respond to questions from referral sources, managers, patients, employees, payors and the general public.
  • Mathematical Skills
  • Ability to calculate and perform basic mathematical calculations such as pharmaceutical calculations, discounts, percentages, and volume.
  • Reasoning Ability
  • Ability to define problems, collect data, establish facts, and draw valid conclusions.

TRAVEL REQUIREMENTS:

This role does not have travel requirements.

PREFERRED QUALIFICATIONS:

  • National pharmacy technician certification preferred.
  • Successful completion of an approved/accredited pharmacy technician training program preferred.
  • Minimum of one (1) year experience with medical insurance authorization in infusion services or other healthcare profession preferred.
  • Minimum of one year customer service preferred.
  • Home infusion experience on the provider or payor side preferred.

Option Care 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.

Posted: Feb 19, 2020

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Option Care 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.

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