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Infusion Pharmacy Intake Coordinator
2 weeks ago
At Memorial Healthcare System (MHS), our ever-growing pharmacy career options present unlimited opportunities to individuals passionate about advancing pharmacy practice. As a nationally recognized and respected leader for providing "A-rated" patient care and safety, MHS prides itself on being able to grow and adapt to the rapidly evolving needs of our community and healthcare industry.
The Pharmacy Intake Coordinator plays a critical and complex role at the intersection of clinical pharmacy operations and health benefit coordination. This position is responsible for managing the intake process for specialty and traditional parenteral therapies, ensuring the timely collection and validation of clinical information, patient eligibility, benefit verification, and prior authorization requirements. It involves a strong understanding of benefit design, including formulary status, plan coverage, copay assistance programs, and 340B program eligibility. The role serves as a liaison between providers, patients, pharmacy staff, and payers, navigating a dynamic environment that requires attention to detail, medical knowledge, and strong communication skills.
Responsibilities include:
- Notifying patients/families regarding insurance coverage and payment responsibilities.
- Ensuring the referral process is completed prior to submitting referral to pharmacy for medication dispense and delivery.
- Communicating and coordinating with home health agencies for patient acceptance, including submission of service orders and other pertinent information required by home health.
- Collecting and inputting medical information into Electronic Medical Records (EMR) applications including diagnosis, medical history, medication history, allergies, etc.
- Assisting with prior authorization process for pharmacy and medical claims.
- Performing test claim submissions for drug, supply items, and durable medical equipment (DME).
- Reviewing and evaluating new referral documents for appropriateness in the outpatient setting.
- Verifying prescriber licensure for referral and updating EMR for billing processing.
- Processing all required paperwork and documentation required for referral acceptance according to department policies.
Competencies include:
- Accountability
- Clinical Documentation Review
- Customer Service
- Documentation
- Effective Communication
- Medical Terminology
- Responding to Change
- Standards of Behavior
- Verifying Insurance
Education and Certification Requirements:
- High School Diploma or Equivalent (Required)
- ARMA Certified Medical Assistant (ARMA) - American Registry of Medical Assistants (ARMA)
- Certified Pharmacy Technician (CPHT) - Pharmacy Technician Certification Board (PTCB)
- Licensed Practical Nurse (PN LICENSE) - State of Florida (FL)
Additional Job Information:
- Complexity of Work: The role requires the ability to multitask and manage time efficiently with minimum supervision. Strong communication, organizational, problem-solving, and interpersonal skills. In-depth understanding of third-party insurance billing practices, as well as federal and state regulations with regard to billing and reimbursement. Knowledge of medical terminology as it relates to infusion therapy and durable medical equipment is strongly recommended.
- Required Work Experience: Minimum of two (2) years of experience in a healthcare setting involving patient intake, insurance verification, or care coordination, preferably in home health, infusion services, specialty pharmacy or a similar field.
- Other Information: Must be a Certified Medical Assistant, LPN, or Certified Pharmacy Technician.
Working Conditions and Physical Requirements:
- Keyboard Entry = 80%
- Lifting or Carrying 0 - 25 lbs Non-Patient = 20%
- Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 20%
- Pushing or Pulling 0 - 25 lbs Non-Patient = 20%
- Reaching = 20%
- Sitting = 80%
- Computer Monitor = 80%
Shift: Days
Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification. Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process. Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity. Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law. We are proud to offer Veteran's Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program. Employment is subject to post offer, pre-placement assessment, including drug testing. If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email TalentAcquisitionCenter@.
