1 Infusion Insurance Liaison - Full Time - Day Job in Houston, TX

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Infusion Insurance Liaison - Full Time - Day

Houston Methodist

Houston, TX | Full Time

$40k-49k (estimate)

2 Weeks Ago

Infusion Insurance Liaison - Full Time - Day

$40k-49k (estimate)

Full Time | Ambulatory Healthcare Services 2 Weeks Ago

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Houston Methodist is Hiring an Infusion Insurance Liaison - Full Time - Day Near Houston, TX

At Houston Methodist, the Infusion Insurance Liaison position is responsible for obtaining insurance authorizations for patients who receive infusion services including those with a diagnosis of cancer requiring complex long-term management for individualized treatment plans. This position works closely with the healthcare team and pharmacy to ensure initial treatments and changes in treatment are financially cleared while utilizing effective communication skills in all interactions with patients, co-workers, insurance companies and healthcare clinical team.

PEOPLE ESSENTIAL FUNCTIONS

Contributes to a positive work environment and to a dynamic, team focused work unit that actively helps one another to achieve optimal department results. Collaborates with all members of the interprofessional health care team by actively communicating and reporting pertinent patient care information and data in a comprehensive manner.

Serves as a liaison for the patient, medical staff, and insurance companies. Communicates to resolve patient access and quality service matters. Keeps open channels of communication with physician, patient, and service areas regarding action taken and resolution.

Trains and mentors new team members.

SERVICE ESSENTIAL FUNCTIONS

Completes financial clearance activities including obtaining insurance authorizations for complex individualized treatments which may extend over long periods of time with frequent modifications. Monitors and tracks authorizations, including ensuring accurate Current Procedural Terminology (CPT) codes, location of service performed, expiration dates and number of treatments performed.

Uses excellent communication skills (verbal, non-verbal, written) to facilitate providing the highest quality service during every patient, physician, guest, employee, or other encounter. Responds promptly to requests by staff, patients, physicians, and other members of the patient care team. Recognizes and responds appropriately to urgent/emergent situations per protocols.

Provides appropriate notification of issues that may result in service delays or denials. Handles add-ons and treatment changes appropriately and as per department protocol.

QUALITY/SAFETY ESSENTIAL FUNCTIONS

Enters patient and authorization data into the electronic medical record system with a high level of thoroughness, accuracy and timeliness. Documents detailed treatment authorization outcomes, including timelines and treatment counts to ensure re-authorization is obtained as needed.

Ensures patient information is conveyed to others appropriately while complying with patient confidentiality and Health Insurance Portability and Accountability Act (HIPAA) regulations.

FINANCE ESSENTIAL FUNCTIONS

Utilizes multiple online resources to initiate and verify authorization needed for prompt submission. Notifies the payer of the patient's admission or procedure in a timely manner to ensure third party reimbursement.

Organizes time effectively, minimizing incidental overtime, and sets priorities. Adheres to productivity standards.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS

Displays initiative to improve job functions; offers suggestions to streamline processes and utilizes increased insurance job knowledge to ensure the latest healthcare policies are applied to financial clearance.

Seeks opportunities to expand learning beyond baseline competencies with a focus on continual development.

This job description is not intended to be all-inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.

EDUCATION

High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)

WORK EXPERIENCE