Position: Intake Specialist/Head Department: Medical Billing / Revenue Cycle Management Location: Work from Office Reports To: RCM Manager
Job Summary:
The Intake Specialist/Head in Medical Billing is responsible for managing patient referrals, verifying insurance eligibility, obtaining prior authorizations/LOA, and ensuring all necessary documentation is collected for seamless billing and claims processing. This role requires excellent communication skills, attention to detail, and a deep understanding of medical billing procedures.
Key Responsibilities:
Referral Intake Processing:
Receive and review patient referrals from providers or healthcare facilities.
Verify patient demographics and insurance details in the system.
Ensure all required documentation (insurance cards, physician orders, prescriptions, etc.) is obtained.
Insurance Verification Authorization:
Verify patient eligibility and benefits with primary and secondary insurance.
Obtain prior authorizations/LOA and approvals as required by the insurance provider.
Track authorization status and follow up on pending requests.
Communicate authorization approvals or denials to the relevant teams.
Data Entry Documentation:
Accurately enter patient and insurance information into the billing system.
Maintain up-to-date records of all referrals, authorizations, and eligibility checks.
Ensure compliance with HIPAA and company policies regarding patient data security.
Coordination Communication:
Act as a liaison between the billing team, providers, and insurance companies.
Communicate with patients regarding insurance coverage, co-pays, and out-of-pocket costs when necessary.
Collaborate with the RCM team to resolve issues related to eligibility, benefits, and authorizations.
Qualifications
Requirements & Qualifications:
Education: Bachelors or Masters degree.
Experience: Minimum of 10 years of experience in med