Pharmacy Intake Coordinator

5 days ago

Orange, California, United States BMR Partners Inc Full time
Job Summary

We are seeking a highly skilled Pharmacy Intake Coordinator to join our team at BMR Partners Inc. As a Pharmacy Intake Coordinator, you will play a critical role in ensuring seamless communication between patients, healthcare providers, and insurance companies.

Key Responsibilities
  • Communication and Coordination: Communicate with patients to obtain necessary information for prescription processing, refills, and insurance benefits verification.
  • Insurance Benefits Investigation: Investigate and verify insurance benefits and eligibility for pharmacy and medical third-party claims.
  • Prior Authorizations and Appeals: Obtain prior authorizations, track progress, and expedite responses from insurance carriers and other payers, while maintaining contact with customers to keep them informed.
  • Clinical Review and Coordination: Review prescribed treatment regimens for accuracy prior to submission of authorization and facilitate appeals processes between patients, physicians, and insurance companies.
  • Service Issue Tracking and Escalation: Track, report, and escalate service issues arising from requests for authorizations, financial assistance, or other issues that delay service.
  • Prescription Transfer and Coordination: Notify patients when prescriptions have been transferred and follow up with specialty pharmacies to confirm receipt.
  • Assessments and Patient Enrollment: Complete mandated assessments and facilitate patient enrollment with manufacturer Hubs when required.
  • Documentation and Compliance: Document case activity, communications, and correspondence in computer systems to ensure completeness and accuracy of patient contact records, while ensuring compliance with regulatory requirements and organizational standards.
Requirements
  • Education: High School Diploma or GED
  • Experience: 1 year of proven work experience in a healthcare setting, with previous intake experience preferred but not required.
  • Skills: Superior telephone customer service skills, healthcare experience with a basic understanding of clinical terms and benefits investigation, strong organization skills, attention to detail, and excellent data management software skills.
  • Certifications: Pharmacy Technician Certification preferred but not required.
Benefits
  • 401(k) Plan
  • Dental Insurance
  • Flexible Spending Account
  • Health Insurance
  • Paid Time Off
  • Vision Insurance
Physical Requirements

Employees in this role must meet certain physical demands to perform the essential functions effectively. Reasonable accommodations will be provided for individuals with disabilities to ensure they can perform these functions.

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