Infusion Phones

Infusion Phones

Job Identification

Job Title Infusion Phones

Reporting to Infusion Manager

Department / CC Infusion

Location Phoenix Administration

Job Reference AARA/Infusion Phones

No. Job Holders 1

Last Update September 15th 2022

2. Job Purpose

An Infusion phone representative is the main contact of any infusion queries. Contact may include;

appointment scheduling/rescheduling, status updates on medication progress, patient responsibility

notification, department transfers and complaint escalation.

3. Job Dimensions

Supervisory/Line Management Authority

None

Area Authority

None

Financial Authority

None

Process Authority

None

Patient Contact

Constant availability to answer calls, questions or concerns

4. Organizational Position

CEO

RCM Director

Infusion Coordination Manager

Infusion Coordination Lead (if applicable)

5. Role of the Department

Assist patients with infusion/injection concerns or questions. As an infusion personnel it is your responsibility to ensure the patients coverage and responsibility for these high-cost dollar drugs. Updating the patient on coverage, scheduling or contacting any members within AARA to provide assistance to the patient as necessary.

6. Key Result Areas

• Managing incoming calls or incoming post services claims work.
• Obtains and inputs pre-authorization insurance and demographic information into the appropriate medical/scheduling system. Verifies patient benefits and eligibility prior to completing referral
• Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient pre-certification, prior authorization, and post service requests.
• Responsible for the identification and data entry of referral requests into the system in accordance with the plan certificate.
• Responds to telephone and written inquiries from clients, providers and in-house departments.
• Conducts clinical screening process.
• Checks benefits for facility-based treatment.
• Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.

7. Equipment, Machinery and Systems

Equipment and Machinery

• Phone
• Printer/Fax

Systems

• Nextgen
• Microsoft Office applications
• Payer portals
• Outlook

8. Assignment and Review of Work

All new AARA employees will agree initial objectives to be assessed on completion of their 90-day initial review period. Thereafter, all employees will enter the annual appraisal cycle under the AARA Talent, Performance and Career Management Policy where annual appraisals will be conducted by their Line Manager and CEO. Further information on the appraisal cycle calendar is available from the HR Manager and from the Talent, Performance and Career Management Policy on the AARA Intranet.

9. Communication and Relationships

The postholder must have strong interpersonal and relational talents. Success in this role involves building and maintaining relationships with internal and external stakeholders

Key Internal Relationships

Infusion Coordinators

Reverification & RVS Management

Infusion Nurses & MAs

Infusion Director

Billing/Claims Manager

Key External Relationships

Insurance payers

Drug representatives

Patients

10. Demands of the Job

Physical

Lifting, Moving and Handling

Patient

Sitting for long periods etc

Mental

Effort/Fatigue

Stress

Knowledge, Skill, Training and Experience to do the Job

Required

• Must be able to work Monday-Thursday from 7:00 a.m. to 6:00 p.m.
• Insurance eligibility and benefits experience
• Prior authorization experience
• Medical terminology
• Must be able to travel as needed

Preferred

• Bilingual in Spanish
• Experience in medical or insurance field, preferred
• NextGen, preferred