Pharmacy Account Coordinator Specialist
1 month ago
The Specialty Pharmacy Account Coordinator plays a vital role in ensuring seamless patient care by coordinating multiple facets of patient account management, including insurance/benefit verification, rejection and denials management, and collections. This position requires a thorough understanding of available programs, funding guidelines, claims procedures, and insurance company regulations, as well as oncology coding and billing.
Key Responsibilities- Verify patient insurance and benefits to ensure accurate billing and reimbursement.
- Manage rejection and denials, resolving issues and ensuring timely resolution.
- Coordinate with patients, physicians, and insurance companies to resolve billing and reimbursement issues.
- Monitor insurance company regulations for changes in pre-certification, documentation, medical necessity criteria, policy requirements, and claims submission requirements.
- Assist patients in enrolling in assistance programs, such as drug copay cards and/or foundations.
- Monitor services rendered and bill assistance programs for applicable funds.
- Some college hours in Business, Finance, and/or Accounting related courses preferred.
- Current State Technician license in good standing.
- A minimum of 3 years related experience required, including 1 year of relevant pharmacy experience.
- Certified Pharmacy Technician (CPhT) by the Pharmacy Technician Certification Board (PTCB) is required within six months from start.
At Mercy, we offer a comprehensive benefits package, including day-one comprehensive health, vision, and dental coverage, PTO, tuition reimbursement, and employer-matched retirement funds. We're committed to providing a supportive community that fosters growth and development.
We're an equal opportunity employer and welcome candidates from diverse backgrounds. If you're passionate about delivering exceptional care and making a difference in the lives of others, we encourage you to apply.
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