What are the responsibilities and job description for the VERIFICATION SPECIALIST position at Healix Infusion Therapy, LLC?
Job Details
Description
Healix Infusion Therapy, LLC is currently seeking a Full Time Verification Specialist to work alongside our nursing team at one of our Infectious Disease Office Infusion Centers located in San Antonio, TX!
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Include the following. Other duties may be assigned.
- Performs/reviews insurance benefit verification for ordered services.
- Obtains/reviews pre-certification, pre-determinations, and/or PCP referrals, as required by payor guidelines.
- Conducts Follow-up on pending intake items needed to approve ordered services.
- Completes financial analysis – enters allowable/fees, assesses client margin, and creates patient financial responsibility estimate based coverage and benefits.
- Notifies Supervisor of financial review outcomes/special pricing requests which fall below the minimums established by Healix policy.
- Issues systemic approval/denial for ordered services.
- Provides status communication/notification throughout the review process.
- May assist in advising patients of insurance benefits, estimated financial responsibility, and copay assistance enrollment processes (as applicable).
- Performs other related duties, as requested
CORE DUTIES AND RESPONSIBILITIES:
Include the following basic performance factors all Healix, Inc. employees are expected to meet.
- Communicates with clients and fellow employees through written and verbal forms, clearly and timely
- Interacts professionally with clients and fellow employees
- Cooperates with team members to accomplish departmental goals
- Accepts and incorporates changes or new ideas into daily work
- Provides service in a responsive, timely and accurate manner to both clients and fellow employees
- Understands and adheres to policies and procedures
- Arrives at work as scheduled and notifies supervisors in a timely manner of any absences
- Recognizes priorities and takes action; makes productive use of time
- Strives to resolve problems and conflicts on his/her own initiative
- Attempts to create new ideas or new procedures working as part of a group or individually.
- As a part of your job you will receive protected health information. It is your responsibility to comply with HIPAA in using and disclosing health information.
About Us
Healix is the nations leader in providing physician office-based infusion services. Focused on patient and physician peace of mind for 35 years, we offer unparalleled capabilities for optimal patient care, comfort, compliance, and clinical outcomes in an outpatient setting.
At Healix, we manage Office Infusion Centers on behalf of physicians, hospitals, and medical institutions, encouraging in-office treatment for optimal patient care. Our company is headquartered in Sugar Land, Texas, a suburb of Houston, where we have helped establish and manage hundreds of infusion centers nationwide. We use our clinical and business expertise to provide integrated solutions to improve all aspects of the infusion program, all while delivering peace of mind to our clients and their patients.
Studies show that the physician office infusion center setting provides significant site of care benefits for patients, communities, and payors, including superior clinical outcomes and lower cost of care. Overall patient satisfaction at Healix-managed infusion centers soars, with 98% of patients rating their care as excellent. Our physician clients rely on Healix to handle all facets of infusion center operations, including drug purchasing, revenue cycle management, managed care programs, and clinical staffing. As Healix continues to leverage unique industry expertise in management and service markets, we are dedicated to maintaining focus on patient and physician peace of mind.
Qualifications
