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Biologics Management Specialist

2 months ago

Palmdale, California, United States Skin and Cancer Institute Full time
Position Overview

Role Summary: The Biologics Coordinator plays a crucial role in ensuring the effective management of specialty medications within a healthcare setting.

Key Responsibilities:

  • Conduct a variety of administrative tasks, ensuring the accuracy and integrity of patient records and medication data.
  • Maintain and update records related to specialty medications and patient documentation.
  • Initiate and manage prior authorization requests for specialty medications.
  • Oversee the Appeals process as necessary.
  • Confirm insurance eligibility for patients.
  • Address any discrepancies in diagnoses that may affect medication usage.
  • Possess a solid understanding of FDA-approved indications for biologic therapies.
  • Facilitate communication among healthcare providers, insurance entities, pharmacies, and patients.
  • Assist patients in enrolling in co-pay and patient assistance programs.

Confidentiality and Compliance:

Adhere to HIPAA regulations and maintain patient confidentiality at all times.

Qualifications:

  • Experience in biologics coordination or specialty pharmacy is essential.
  • Demonstrated critical thinking, sound judgment, and meticulous attention to detail.
  • Prior experience in a dermatology practice or similar healthcare environment is required.
  • Familiarity with medical terminology and procedures specific to dermatology is necessary.
  • Proficiency in the CoverMyMeds software program is required.
  • Knowledge of ICD-10 codes, J codes, and CPT codes is essential.
  • Understanding of pharmacy operations, including benefits, dosing, prior authorizations, and patient assistance programs.
  • Exceptional verbal and written communication skills are a must.
  • Strong customer service abilities, with a focus on compassionate patient care.
  • Excellent skills in data entry, proofreading, and record management.
  • Organizational skills with the capacity to multitask and prioritize effectively.
  • Ability to maintain professionalism and confidentiality in handling sensitive patient information.
  • Capacity to work independently with minimal supervision.
  • A high school diploma or equivalent is required; additional education or certification in a relevant field is advantageous.