Core Competencies:
- Ethics. Works with integrity; Upholds organizational values
- Dependability. Follows instructions, and responds to management direction; results oriented and committed to achieving objectives and tasks as required
- Teamwork and Collaboration. Exhibits objectivity and openness to other’s views; Gives and welcomes feedback; Contributes to building a positive culture. Communicates effectively
- Professionalism. tactfully approaches others; Reacts well under pressure; Treats others with respect and consideration; Accountable for all actions and decisions
- Organizational Support. Follows policies and procedures; Completes administrative tasks correctly and on time; Supports organization’s goals and values
- Quality Management. Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness
- Decision Making. Analyzes each situation, looking for opportunities to make any situation more beneficial for the company. Participates effectively in communication to achieve optimum results
Job Overview:
The Remote Clinical Intake Specialist is responsible for receiving, reviewing, and processing all incoming referrals for parenteral nutrition (PN, IDPN, TPN, IPN), and home infusion therapies. Working fully remotely, the Intake Specialist ensures accurate clinical documentation, timely coordination with providers, and compliance with payer and accreditation standards. This role is essential to onboarding new patients, gathering medical necessity documentation, and supporting the pharmacist team in initiating therapy quickly and safely.
Key Responsibilities:
- Remote Referral Intake & Clinical Review Log and review referrals received primarily via fax and email.
- Ensure all clinical documents are complete: diagnoses, anthropometrics, allergies, labs, PN indication, access type, clinical notes.
- Download additional records from EMRs.
- Request missing documentation from hospitals, dialysis centers, and MD offices via phone, secure email, and portal messaging.
- Prepare detailed intake summaries for pharmacist review.
- Remote Insurance Verification & Prior Authorization Support: Obtain and confirm insurance coverage for Medicare, Medicaid, commercial, and supplemental plans using payer portals and verification tools.
- Request prior authorization (PA) if needed for the patient’s insurance plan(s).
- Assemble documentation for: PN medical necessity, ONS failure, Contraindications to enteral feeding, Malabsorption of gastrointestinal (GI) tract (required for Medicare LCD), OON gap exception requests and Continuity of care
- Communicate electronically with payers regarding PA status and additional clinical needs.
- Remote Communication & Care Coordination
- Act as the central clinical point of contact for providers, dialysis units, referral coordinators, and nursing agencies.
- Coordinate home-nursing start-of-care visits, lab draws, and line assessments remotely.
- Provide timely updates to internal teams: pharmacists, reimbursement staff, delivery coordinators, billing department and management.
- PN/TPN-Specific Clinical Intake Responsibilities
- Review PN/TPN orders for accuracy: macronutrients, electrolytes, infusion rate, cycling requirements, filters, access type.
- Ensure SWO/SMN/CMN forms are complete, compliant, and signed.
- Track required clinical data remotely:Height, weight, BMI,CMP, CBC, Magnesium, Phosphorus, Liver panel, triglycerides, and Albumin/prealbumin
- Document oral intake failure, contraindications to feeding tube placement, or GI dysfunction per payer criteria.
- Support pharmacists by preparing clean, complete PN clinical documentation.
- Compliance & Accreditation Duties: Maintain patient intake files according to ACHC, CHAP, URAC standards within the digital EMR.
- Ensure all remote communication meets HIPAA and privacy requirements.
- Follow internal SOPs for remote intake workflow, triage, communication, and documentation.
- Participate in remote QA/QI meetings, huddles, and audits.
- Administrative & EMR Work
- Enter all patient demographics, referral details, and clinical information into the EMR (Brightree).
- Upload and categorize documents into correct modules for pharmacist access.
- Maintain remote task lists, intake queues, and daily activity logs.
- Assist with remote scheduling of deliveries and start-of-care timelines.
Requirements:
- Licensed in NY preferred, multi-state license better.
- Prior home-infusion intake or PN intake experience.
- Knowledge of CMS Parenteral Nutrition LCD, dialysis PN criteria, and commercial payer policies.
- Familiarity with CareTend, Brightree, or similar EMR systems.
- Experience coordinating home health nursing or lab draws remotely.
