Medical Insurance Benefits Coordinator
4 weeks ago
The Medical Insurance Benefits Specialist will be responsible for performing benefit investigations and obtaining prior authorizations for both new and existing patients to process patient prescription orders in a timely manner while demonstrating excellent customer service to patients, healthcare professionals, and insurance carriers.
Key Responsibilities- Assist the insurance department with continuation authorizations
- Run benefits and gather all necessary documents to submit authorizations for commercial insurance
- Check the status daily on pending authorizations
- Conduct patient chart audits
- Maintain current files and other records in accordance with CSI Pharmacy instructions and requirements
- Make outreach efforts to insurances, patients, specialist offices, and care teams as set forth by department guidelines and clinical priorities
- Coordinate with Intake personnel and assist with work duties
- Interact collaboratively with clinical staff and insurance
- Provide accurate data entry of referral or authorization information into the electronic medical record
- Send complete information to patient's insurance (when applicable) and referring specialist to coordinate referral
- Complete and submit all required reports in a timely manner
- Comply with all Company policies, instructions, and directives for the fulfillment of company objectives and maximum profitable sales
- Utilize operating systems and tools to help manage patient therapy and refill compliance
- Provide high-quality services to home-care patients and to home-care referral sources
- Attend and participate in conventions, trade shows, and in-services relating to IV therapy as appropriate
- Consistently represent the company in a professional manner
- Maintain effective working relationships and cooperate with all personnel in the Company
- Adhere to the Company's compliance requirements as stated in the policy and procedure manual and all other related policies
- Perform other duties and responsibilities as assigned
- Provide the highest level of professionalism, responsiveness, and communication to build and maintain the maximum customer base possible
- Must possess the ability to multi-task and frequently change direction
- Analytical and problem-solving skills
- Attention to detail
- Experience working in Microsoft Office, specifically Excel, Outlook, Teams, and Word
- High School Diploma or equivalent GED is required, at minimum. College or technical college preferred
- Minimum one year in pharmacy or healthcare environment
- Knowledge of Medicare, Medicaid, and third-party vendors
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