Pharmacy Precertification Specialist
4 weeks ago
About IHTC
At the Indiana Hemophilia & Thrombosis Center (IHTC), we offer a future where people with rare blood disorders flourish. Our experts provide the highest quality comprehensive services and holistic care to patients with bleeding, clotting and other hematologic disorders, and to their families.
What You Will Do
As a Pharmacy Precertification Specialist, you will be responsible for verifying patient eligibility with payers and works in conjunction with the pharmacy staff and providers to coordinate referrals, precertification, or prior authorizations for medications.
The Opportunity
Secure appropriate medical documentation requested by third-party insurance providers.
Verify insurance coverage for pharmacy benefits.
Prior to expected date of service, prepare and submit precertification and prior authorizations to physicians, hospitals, and third party payers. Follow up with patients, insurance companies, pharmacy staff, and physicians regarding denials, working with providers and staff to resubmit paperwork to obtain an approval.
Notify patients, providers, and front office staff prior to date of service if referrals, precertification, or prior authorizations are not approved. Facilitate appointment rescheduling as necessary and ensure correct reporting of patient diagnosis and procedures
Remain up-to-date on outpatient billing and benefit changes for third-party insurance carriers. Maintain compliance with all government and non-government insurance company policies and procedures as they relate to outpatient services
Ensure correct reporting of patient diagnosis and procedure coding.
Ensure compliance with LCS/NDC's are adhered to as needed. Communicate findings to providers/fellow team members, and billing manger as needed.
Prepare and submit pharmacy claims to third party insurance carriers
Secure appropriate medical documentation as required by third party insurance carriers.
Follow up with third party insurance carriers and patients on unpaid claims or balances.
Research payer regulations and claim guidelines on payment and claim submission criteria to ensure compliant billing practices by utilizing website and associated tools established for payers as applicable.
Verify insurance coverage for pharmacy services prior to services being rendered.
Ensure accurate and thorough documentation of steps taken to resolve claim issues are recorded in billing software(s).
Monitor claims for accuracy and authorization. Communicate claim issues to team lead and/or billing manager on a regular basis.
Work with team lead/manager to establish weekly, monthly and annual goals and communicate associated progress as needed.
Requirements
High school diploma or GED
Minimum 3 years of related experience
Valid Indiana Driver's license and automobile insurance
Benefits
Why join our team?
The IHTC is a not-for-profit program based in Indianapolis and offers a competitive salary and benefit package.
The IHTC is the only federally designated comprehensive hemophilia program in Indiana and serves the entire state through services available in Indianapolis and at outreach clinics.
The IHTC is a leader in hemophilia care, education and clinical research and has a dedicated on-site multidisciplinary staff to ensure availability of a wide range of required services.
The IHTC participates in national and international clinical research, including new infusion products and therapies, investigation of long-term outcomes, and the impact of associated conditions. The IHTC research program provides patients access to new therapies, and an opportunity to improve care. Our center has more than 50 clinical research projects involving bleeding disorders, sickle cell disease, thrombosis and more.
The Indiana Hemophilia and Thrombosis Center is an Equal Opportunity Employer.
#J-18808-Ljbffr
-
Pharmacy Precertification Specialist
7 days ago
Indianapolis, United States Indiana Hemophilia and Thrombosis Center Full timeAbout IHTC At the Indiana Hemophilia & Thrombosis Center (IHTC), we offer a future where people with rare blood disorders flourish. Our experts provide the highest quality comprehensive services and holistic care to patients with bleeding, clotting and other hematologic disorders, and to their families. What You Will Do As a Pharmacy Precertification...
-
Pharmacy Precertification Specialist
3 weeks ago
Indianapolis, United States Indiana Hemophilia & Thrombosis Center Full timeJob DescriptionJob DescriptionAbout IHTCAt the Indiana Hemophilia & Thrombosis Center (IHTC), we offer a future where people with rare blood disorders flourish. Our experts provide the highest quality comprehensive services and holistic care to patients with bleeding, clotting and other hematologic disorders, and to their families.What You Will DoAs a...
-
Precertification Specialist
2 weeks ago
Indianapolis, United States Indiana Hemophilia & Thrombosis Center Full timeJob DescriptionJob DescriptionAbout IHTCAt the Indiana Hemophilia & Thrombosis Center (IHTC), we offer a future where people with rare blood disorders flourish. Our experts provide the highest quality comprehensive services and holistic care to patients with bleeding, clotting and other hematologic disorders, and to their families.What You Will DoAs a...
-
Precertification Specialist
7 days ago
Indianapolis, United States Indiana Hemophilia and Thrombosis Center Full timeAbout IHTC At the Indiana Hemophilia & Thrombosis Center (IHTC), we offer a future where people with rare blood disorders flourish. Our experts provide the highest quality comprehensive services and holistic care to patients with bleeding, clotting and other hematologic disorders, and to their families. What You Will Do As a Precertification Specialist, you...
-
Oncology Pharmacist
4 weeks ago
Indianapolis, United States Jackson Pharmacy Full timeJackson Pharmacy Professionals is searching for a contract Oncology Pharmacist for a great inpatient hospital environment in Indianapolis, IN. This is a full-time Pharmacist position (day shift, some after hour calls required). Permanent position. Oncology Pharmacist - Clinical Pharmacy Specialist Position Details: Inpatient hospital setting Bone...
-
Oncology Clinical Pharmacy Specialist
2 weeks ago
Indianapolis, United States Community Health Network Full timeClinical Pharmacy Specialist -Oncology Join Community Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, "community" is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve...
-
Clinical Pharmacy Specialist- Ambulatory
2 weeks ago
Indianapolis, United States Community Health Network Full timeClinical Pharmacy Specialist -Ambulatory Care Join Community Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, "community" is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we...
-
Clinical Pharmacy Specialist- Ambulatory
2 weeks ago
Indianapolis, United States eCommunity Full timeClinical Pharmacy Specialist -Ambulatory Care Join CommunityCommunity Health Network was created by our neighbors, for our neighbors. Over 60 years later, community is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve...
-
Indianapolis, United States Community Health Network Full timeCardiology Clinical Pharmacy Specialist Ambulatory This position is located at our South Hospital. Join Community Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, "community" is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art...
-
Indianapolis, United States Community Health Network Full timeInfectious Disease Clinical Pharmacy Specialist -Ambulatory Care Join Community Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, "community" is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in...
-
Indianapolis, United States eCommunity Full timeInfectious Disease Clinical Pharmacy Specialist -Ambulatory Care Join CommunityCommunity Health Network was created by our neighbors, for our neighbors. Over 60 years later, community is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the...
-
Indianapolis, United States Community Health Network Full timeHoursMonday - Friday 8:00am - 4:30pmFull-timeBi-weekly, Benefited.ScheduleFull-time*_Infectious Disease Clinical Pharmacy Specialist –Ambulatory Care_****Join Community*Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, “community” is still the heart of our organization. It means providing our neighbors with...
-
Pharmacy Liaison
2 weeks ago
Indianapolis, United States AndHealth Full timePatient Engagement Specialist Full Time Indianapolis, IN AndHealth is a healthcare technology company created to help people reverse chronic disease. We are driven by the goal of making world-class specialty care accessible and affordable to all. We partner with health systems, community health centers, plans, and employers to remove barriers to care to...
-
Pharmacy Liaison
3 weeks ago
Indianapolis, United States AndHealth Full timeJob DescriptionJob DescriptionPatient Engagement SpecialistFull TimeIndianapolis, INAndHealth is a healthcare technology company created to help people reverse chronic disease. We are driven by the goal of making world-class specialty care accessible and affordable to all. We partner with health systems, community health centers, plans, and employers to...
-
Pharmacy Liaison
2 weeks ago
Indianapolis, United States AndHealth Full timePatient Engagement SpecialistFull TimeIndianapolis, INAndHealth is a healthcare technology company created to help people reverse chronic disease. We are driven by the goal of making world-class specialty care accessible and affordable to all. We partner with health systems, community health centers, plans, and employers to remove barriers to care to ensure...
-
Clinical Pharmacy Specialist
2 weeks ago
Indianapolis, United States Community Health Network Full timeThis position is located at our Cancer Center North Campus. Join Community Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, "community" is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the...
-
Rheumatology Clinical Account Specialist
2 weeks ago
Indianapolis, United States UCB Full timeMake your mark for patients To strengthen our Rheumatology Sales Team, we are looking for a talented individual to fill the position of: Rheumatology Clinical Account Specialist - Indianapolis South. As an Rheumatology Clinical Account Specialist (CAS) you will be responsible for driving demand for the assigned product, CIMZIA (certolizumab pegol), by...
-
Full Time Internal Medicine Physician
3 weeks ago
Indianapolis, Indiana, United States Enterprise Medical Recruiting Full timeEnterprise Medical Recruiting is assisting a rapidly growing Federally Qualified Health Center (FQHC) in Northwest Indiana with the recruitment of internal medicine physicians. We are seeking qualified, enthusiastic providers with a passion for the underserved patient population. OpportunityOutpatient-only clinics - patients are seen on both a scheduled and...
-
Full Time Internal Medicine Physician
4 weeks ago
Indianapolis, Indiana, United States Enterprise Medical Recruiting Full timeEnterprise Medical Recruiting is assisting a rapidly growing Federally Qualified Health Center (FQHC) in Northwest Indiana with the recruitment of Internal medicine physicians. We are seeking qualified, enthusiastic providers with a passion for the underserved patient population. OpportunityOutpatient-only clinics - patients are seen on both a scheduled and...
-
Full Time Internal Medicine Physician
4 weeks ago
Indianapolis, Indiana, United States Enterprise Medical Recruiting Full timeEnterprise Medical Recruiting is assisting a rapidly growing Federally Qualified Health Center (FQHC) in Northwest Indiana with the recruitment of Internal medicine physicians. We are seeking qualified, enthusiastic providers with a passion for the underserved patient population. OpportunityOutpatient-only clinics - patients are seen on both a scheduled and...
