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Pharmacy Care Coordinator

2 months ago

Largo, Florida, United States BayCare Health System Full time

About BayCare Health System

BayCare Health System is a leading healthcare provider in the Tampa Bay area, consisting of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers, and thousands of physicians. Our network is built on a foundation of trust, dignity, respect, responsibility, and clinical excellence.

Job Summary

We are seeking a highly skilled Pharmacy Care Coordinator to join our team at BayCare HomeCare. As a Pharmacy Care Coordinator, you will play a critical role in providing outstanding customer service to our community by processing new referrals, verifying patient information, and communicating with referral sources and patients.

Responsibilities

  • Process new referrals and verify all necessary information is included in the referral
  • Enter new referrals and updates all existing patient information into the corporate IS systems
  • Verify all referrals meet all regulatory, payer, and safety requirements
  • Create pharmacy packets and communicate information to the referral source and patient
  • Verify insurance and benefits for all Medicare, Managed Care, and Private Fee for Service Plans
  • Utilize the correct payer and diagnoses codes
  • Understand medical criteria for securing all required information from the referral source
  • Enter the appropriate financial information into the EHR
  • Timely request and communication of authorizations to payer and documentation in EHR
  • Advise the patient and referral source on Medicare and Managed Care guidelines and reimbursement issues as needed
  • Perform ICD-10 coding of referrals
  • Timely response to referral sources, providers, and leadership is essential
  • Monitor and communicate referral source activity acting as one point of contact for referral sources, home health, and home infusion

Requirements

  • High School or Equivalent
  • Preferred Experience: 1 year infusion related experience, 1 year insurance verification experience, 1 year pharmacy experience, Computer proficiency in Microsoft Office and Excel is preferred

What We Offer

BayCare offers a competitive total reward package that may include health, dental, vision, paid time off, tuition reimbursement, 401k match and additional yearly contribution, yearly performance appraisals with merit increases, yearly team award bonus, and community discounts.