Patient Insurance Coordinator

1 day ago


Pittsburgh, Pennsylvania, United States Medix Full time
Job Title: Patient Insurance Coordinator

We are seeking a dedicated and detail-oriented Patient Insurance Coordinator to join our team at Medix. As a key member of our pharmacy technology company, you will play a crucial role in improving patient care and access to prescription medications.

Responsibilities:
  • Process pharmacy claims accurately and timely to meet client expectations.
  • Analyze and triage rejected pharmacy insurance claims to determine patient coverage.
  • Assist in initiating new prior authorization requests with providers and identify the correct forms needed based on patient insurance.
  • Collaborate with prescribers and medical offices to ensure all necessary information is accurately provided on prior authorization forms.
  • Regularly follow up with medical offices to check the status of prior authorization requests and communicate updates to patients and providers.
  • Work with medical offices to handle appeals as needed.
  • Address internal inquiries related to prior authorization requests.
  • Ensure compliance with patient assistance program guidelines and document all findings according to operating procedures.
  • Conduct necessary research using available resources while maintaining the confidentiality of patient and proprietary information.
Requirements:
  • High school diploma or GED required; Bachelor's degree preferred.
  • Minimum one year of healthcare experience, preferably in pharmacy, resolving third-party claims.
  • Strong verbal and written communication skills.
  • Technical proficiency and analytical ability.
  • Excellent judgment and operational focus.
  • A commitment to providing exceptional patient care.
  • Ability to work collaboratively with peers and across departments.
  • Strong aptitude for learning complex software systems.
Work Schedule:

Monday - Friday: 8:00 AM - 9:30 PM, Saturday: 9:00 AM - 5:00 PM. (40 Hours a week)

Flexibility Required: During Q4, candidates must be flexible to work an 8-hour shift within the operating hours. One Saturday a month is expected, with a midweek day off scheduled in return. Schedules will be provided with approximately two weeks' notice.



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