BioScrip, Inc. Intake/Authorization Specialist in Southborough, Massachusetts

Intake/Authorization Specialist

Location: Southborough, MA

Job Id: 5208

of Openings: 1

BioScrip, Inc. is the largest independent national provider of infusion and home care management solutions, with approximately 2,100 teammates and nearly 70 service locations across the U.S. BioScrip partners with physicians, hospital systems, payors, pharmaceutical manufacturers and skilled nursing facilities to provide patients access to post-acute care services. BioScrip operates with a commitment to bring customer-focused pharmacy and related healthcare infusion therapy services into the home or alternate-site setting. By collaborating with the full spectrum of healthcare professionals and the patient, BioScrip provides cost-effective care that is driven by clinical excellence, customer service, and values that promote positive outcomes and an enhanced quality of life for those it serves. Ours is a fast-paced dynamic work environment with room for new ideas and opportunities for career advancement. We offer a wide array of welfare benefits as well as Tuition Reimbursement, an Employee Referral Program, and a 401(k) Retirement Savings.

Due to our exceptional growth and success, we are recruiting for an Intake/Authorization Specialist to join our team.


This position is responsible for processing all new patient referrals, managing current patient base and providing support to the Intake/ Authorization Manager. The main objective is to clear all patients prior to service in order to ensure proper payment in compliance within all legal and regulatory parameters, in cooperation with all other branch departments, and as an efficient and profitable business center.


To perform this job successfully, an individual must be able to perform each essential function satisfactorily, with or without reasonable accommodation.

  • Evaluates referrals against branch service model parameters.

  • Complies with reimbursement for products and services in compliance with Company policy and goals, to include drug, supply, and equipment selection and utilization, and participates in the submission of clean claims through compliance to proper pharmacy billing procedures.

  • Communicates with various payors, referral source, patients and sales representatives.

  • Verifies eligibility and benefits accurately and in a timely manner in accordance with Company policies.

  • Obtains initial authorizations following Company policy and maintains authorizations extension for all patients as appropriate. May obtain written prescription orders from physicians.

  • Processes all required paperwork according to established procedures. Ensures all documentation needed for billing is collected prior to or soon after accepting the referral.

  • Answers telephone calls and emails in a professional and timely manner.

  • Attends all required in services throughout the year.

  • Assists in training of new staff members as needed.

  • Works independently on other projects as assigned.

  • Assists with rollouts of new policies and procedures.

  • Attends all required in services throughout the year.

  • Works independently on other projects as assigned.

  • Each employee is responsible for adhering to those performance programs, policies, procedures, guidelines and internal control standards established to guide the operation of the Company. Each employee must be made aware of and understand proper internal control procedures associated with their specific job function as communicated by his/her manager.

  • Each employee is responsible for reporting concerns that he or she may have with respect to deficiencies in internal control.

  • Performs other duties as assigned.


  • High school diploma or equivalent is required.

  • National pharmacy technician certification preferred.

  • Successful completion of an approved/accredited pharmacy technician training program preferred.

  • Minimum of three (3) years of experience with medical insurance authorization in infusion services or other healthcare profession.

  • Minimum of one year customer service required.

  • Home infusion experience on the provider or payor side is required.

  • Experiential requirements may be waived in lieu of evidence of progressive growth in and attainment of the skills necessary to perform the required duties.


The requirements listed below are representative of the knowledge, skill, and/or ability required, with or without reasonable accommodation.

  • Knowledge of HCPC Codes and ICD-9 Codes and maintains up to date professional knowledge of Medicare, Medicaid and the insurance industry requirements for qualifying services.

  • Ability to foster a cooperative work environment.

  • Strong interpersonal and communication skills and the ability to work effectively with branch departments.

  • Knowledge of computerized information systems, including financial applications.

  • Knowledge of infusion pharmacy, durable medical and respiratory equipment reimbursement for state, federal and commercial payors.

  • Basic pharmacy knowledge of reading and interpreting prescriptions

  • Ability to develop and maintain recordkeeping systems and procedures.

  • Knowledge of the computer and its capabilities.

  • Working knowledge of medical terminology.

  • Ability to perform work in an organized fashion with focus on complete information and time related deadlines.

  • Ability to complete multiple projects with time sensitive deadlines.

  • Ability to manage more than one priority project at a time.

  • Ability to work as part of a team to complete assigned tasks.

  • Ability to exercise independent judgment and at times work independently.

  • Ability to accept direction and complete work according to instruction.

  • Ability to enlist cooperation of other people and department in completing assigned work and projects.

  • Ability to work under high levels of stress.

  • Ability to prioritize and handle multiple tasks and projects concurrently.

  • Demonstrated knowledge and proficiency in the principles, procedures and best practices related to this position.

  • Excellent verbal and written communication skills.

  • Proficient level of software proficiency in using PC software to support activities, especially Microsoft Office, ACT, CPR+.

  • Ability to work with confidential material and maintain confidentiality along with sensitivity to employee’s needs and data.

  • Strong attention to detail.

  • Strong analytical skills.

Language Skills

Ability to read, analyze and interpret information appropriate to duties and responsibilities assigned. Ability to operate information systems, follow policy, complete required forms, and prepare reports. Ability to effectively present information and respond to questions from referral sources, managers, patients, employees, payors and the general public.

Mathematical Skills

Ability to calculate and perform basic mathematical calculations such as pharmaceutical calculations, discounts, percentages, and volume.

Reasoning Ability

Ability to define problems, collect data, establish facts, and draw valid conclusions.

BioScrip is an equal opportunity employer. All employment decisions are made without regard to age, color, race, ancestry, national origin, disability, genetic information, military status, religion, creed, sex, pregnancy, childbirth, marital status, citizenship, sexual orientation, gender identity, gender expression, legally protected medical condition, or any other basis prohibited by applicable law. Background checks and drug screens are part of our hiring process. Affirmative Action/Equal Opportunity Employer, Minority/Female/Disabled/Veteran.