Shields Health Solutions
RxTriageLiaison(Infusion)
“RxTriage Liaison (Infusion) at Shields Health Solutions. Skills: process management, cross-functional coordination, vendor/stakeholder management, operational metrics, resource planning, continuous improvement, Referral Intake, insurance plans, authorization processes, medical problem-solving, critical-thinking skills, infusion therapy, medical reimbursement, pre-certification, benefits investigation, prior authorization, financial assistance, infusion workflows, specialty pharmacy, home infusio”
What You'll Achieve.
timely access to care; fast, accurate routing decisions based on payer rules, clinical factors, and operational constraints
Industry & Context.
medical problem-solving; critical-thinking skills; critical thinking
onsite in Durham, NC for the first 6-8 weeks of training, hybrid 2-3 days a week onsite after training, deals with highly sensitive and private data
What They're Looking For.
Must Have
3+ experience as a pharmacy technician required, 3+ years’ experience with infusions, coordinating and subcontracting referrals, infusion and medical reimbursement experience must include medical pre-certification, benefits investigation, prior authorization, and financial assistance
Nice to Have
Experience with infusion, specialty pharmacy, and/or home infusion workflows strongly preferred, medical pre-certification, benefits investigation, prior authorization, and financial assistance strongly preferred, Familiarity with J‑codes, HCPCS codes (including per diem and nursing), and common infused medications highly beneficial
What You'll Do.
and directing incoming prescriptions and HCPA referrals to the appropriate site of care
ensuring patients are routed efficiently based on insurance requirements
reimbursement feasibility
and operational capacity
acting as the first decision point in the referral workflow process
supporting a specific specialty clinic/s or being part of a centralized intake team serving multiple clinics and disease states/diagnosis requiring infusion therapy
How You'll Work.
Team & Collaboration
collaborates with pharmacy, nursing, intake, revenue cycle management, and clinical partners
Communication Scope
verbal and written communication skills; listener/communicator
Applying for this RxTriage Liaison (Infusion) role?
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