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Program Support Supervisor
3 months ago
A career with us is more than just a job. It's an opportunity to connect and care for our patients, providers, communities and each other.
We attract extraordinary people who have a strong desire to live our mission - to better the lives of those battling cancer and rare diseases.
Compassion is more important than numbers. We value teamwork, respect, integrity, and passion.
We succeed when you do, and our company and management team work hard to foster an environment that provides you with opportunities for both professional and personal growth.
ConnectMed360 is a unique model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers.
Starting salary:
$60K and up
We offer a variety of benefits including:
Medical; Dental; Vision
401k with a match
Paid Time Off and Paid Holidays
Quarterly Incentive Bonuses
Tuition Reimbursement
Company paid benefits – life; and short and long-term disability
Summary:
The Program Support Supervisor is responsible for supervising the accuracy and timeliness of the program's billing function, prescription fulfillment process, and pharmacy/medical benefits investigations.
Major responsibilities:
Manages the verification of current coverage with third party payers and obtains authorizations as needed.
Helps with the resolution of billing issues such as claim resubmissions to all payers, changes in coverage, and claims adjustments.
Ensures that all prescriptions are billed in accordance with Medicare/DMEPOS regulations and that all required information is documented on the hardcopy prescription.
Communicates as required with client/patients about billing issues, including the results of applications for financial hardship assistance and other responses to customer inquiries about billing.
Communicates as required with manufacturer sales representatives.Coordinates and participates in conference calls with manufacturer partners when requested.
Oversees record keeping so that all information is accurate and complete and manages the flow of up-to-date information between billing department and other parts of the Company, such as the accounts receivable, accounts payable and customer service departments.
Generates and analyzes reports.Assists with developing, reviewing, and suggesting changes to prescription fulfillment department policies and procedures as needed.
Ensures ongoing compliance with all laws and regulations; ensures the department meets or exceeds accreditation standards; and implements ''best practices' in all departmental activities.
Delegates authority when necessary to ensure that all responsibilities of this position are fulfilled in a timely and accurate manner.
Helps with the completion of pharmacy and medical cases when needed.Assists with managing and training staff in benefits investigations.
Monitors daily calls/cases/chats.
Other duties as assigned.
Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards
Position Qualifications:
Education/Learning Experience:
Required:
Associate's Degree or equivalent from a 2-year college or technical school, or certificate program in pharmacy and/or healthcare
Work Experience:
Required:
Minimum of two years' pharmacy experience
Desired:
1 to 3 years' experience in Healthcare Management, preferred
Skills/Knowledge:
Required:
Ability to organize and plan the activities of team, delegate appropriately, provide superior level of customer service, and computer experience to include accounting and billing software.
Must be a team player.Desired:
Licenses/Certifications:
Required:
Registration/Certification with Board of Pharmacy as required by law
Desired:
Certified Pharmacy Technician (PTCB)
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