Benefits Coordinator
3 weeks ago
At Amber Specialty Pharmacy, we are committed to delivering exceptional patient care. Our team is dedicated to making a positive impact on patients with complex and chronic conditions.
Hiring Requirements:
- $1,000 hiring bonus
- $1,000 bonus at six months of employment
- Monday-Friday work schedule
- Hours: 8:00 a.m. - 7:00 p.m. CST; varied shifts
- No weekends
- Six paid holidays
- Post-offer, pre-employment drug background tests
This is an office-based position that requires a working knowledge of all necessary computer software to perform job duties. The Benefits Specialist will be responsible for ensuring accurate insurance information is received, stored, and current benefits are verified upon receipt of new and/or renewal referrals for patients.
Key Responsibilities:
- Investigate pharmacy and medical benefits to determine appropriate and accurate coverage of prescribed medication
- Ensure timely reimbursement at maximum allowable rates
- Communicate with patients, caregivers, insurance companies, providers, and Pharma (if applicable)
- Notify staff of relevant information gathered during calls
- Perform complete benefits investigation, including prior authorization and medical vs pharmacy determination
- Complete all payer documentation, including Medicare Certificates of Medical Necessity and DME Information Forms
- Act as a liaison between the Company, insurance companies, co-pay assistance sources, and provider's offices
- Prepare and transmit eligibility inquiries to determine coverage
- Create patient's estimated cost of benefits with all pertinent information
The Benefits Specialist will work closely with the Lead Benefits Specialist, Senior Manager - Revenue Cycle, and other internal management and staff to ensure accurate and timely benefits verification. The ideal candidate will have a working knowledge of the healthcare industry, specifically the pharmacy industry, and be able to maintain confidentiality of patient and employee information.
Requirements:
- Working knowledge of the healthcare industry, specifically the pharmacy industry
- HIPAA training and ability to work with confidential patient and employee information
- One (1) year experience in Benefits
- High school diploma or equivalent
The Benefits Specialist will work in a normal office environment and will be required to lift and traverse the area to move paper and supplies to use the equipment. The ideal candidate will be able to communicate information and ideas so others will understand and be able to observe details at close range.
Equipment Used to Perform Job:
- Computers, keyboards, mouse, monitors, fax, and/or headsets for phone work
- Software specific to the position, including but not limited to Microsoft Outlook and Skype
The Benefits Specialist will be required to complete background checks, including drug testing, criminal conviction history, references, OIG, and other relevant information as allowed by city, state, agency, organizations, or federal requirements/law.
Confidentiality:
This position is required to complete background checks, including drug testing, criminal conviction history, references, OIG, and other relevant information as allowed by city, state, agency, organizations, or federal requirements/law.
Candidates must be able to pass a pre-employment drug test, background check, and health screening (if applicable).
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