Medical/Pharmacy Insurance Verification Coordinator
Location:
Frisco , Texas
Posted:
January 05, 2017
Reference:
00001GN4

We invite you to explore the award-winning culture, people, rewards and opportunities that make AmerisourceBergen so special. Make your next career choice a confident one. We have are currently seeking Medical/Pharmacy Insurance Verification Coordinators . This role will be responsible for supporting all patients to ensure the prescribed drug therapy and pharmacy care plan are followed as prescribed and also meet the medical, social and personal needs of the patient.

US Bioservices has managed specialty pharmaceuticals since its inception in 1994. We use a national approach that recognizes the differences in regional care. We coordinate pharmacy, nursing and benefits so that the patient and the physician have fewer administrative concerns and can focus on achieving the outcomes they desire. The therapeutic expertise of US Bioservices enables us to customize solutions that effectively meet the unique challenges faced in today's healthcare environment.

PRIMARY DUTIES AND RESPONSIBILITIES:
  • Provides intake services and setup for all new patients
  • Verify benefits on both pharmacy and major medical plan
  • Review clinical documents for prior authorization/ pre-certification submission purposes
  • Initiate, complete (when allowable) and tirelessly pursue Prior Authorization approval from insurance carriers and offer to go above and beyond to assist and support our MDO practices whenever possible
  • Coordinates the patient's care with physician offices, nurses, pharmacists and patients.
  • Performs accurate and timely insurance verification, both major medical and pharmacy benefits.
  • Coordinates prescription deliveries and refills for patients.
  • Works with home health nursing visits and maintenance of a patient census throughout the course of their therapy.
  • Supports other team members in the healthcare team.
  • Ensures a continuous quality improvement customer service approach by proactively identifying areas of improvement and communicating those ideas to the healthcare team.
  • Maintains current documentation related to the patients drug therapy and pharmacy care plan. Flag issues that need to be addressed.
  • Coordinates responses and resolutions to issues with appropriate internal and external parties.
  • Nurture/foster strong supporting relationship with every physician's offices.
  • Actively participates in roundtable discussions with Pharmacists, Nursing Services and Pharmacy Care Coordinators to review cases and related drug therapy and pharmacy care plan issues.
  • Maintains and promotes positive and professional working relationships with associates and management.
  • Performs related duties as assigned.

Total Rewards
Compensation for this position includes base salary plus bonus, depending on company financial results and individual performance. Our commitment to our associates includes offering benefit programs that are comprehensive, competitive and will meet the needs of our associates. Some of our benefits include:
  • Healthcare for associates and their families, including eligible domestic partners
  • Paid time off, including vacations and holidays
  • Paid sick time off
  • Paid volunteer time off
  • Life insurance and disability protection
  • Retirement benefits

We take a balanced approach to the benefits we provide. Many benefits are company-paid, while others are available through associate contribution. Specific benefit offerings can vary by location.


Qualifications:
Qualifications:

Requires broad training in fields such as business administration, accountancy, sales, marketing, computer sciences or similar vocations generally obtained through completion of a four year Bachelor's Degree Program or equivalent combination of experience and education. Normally requires one (1) to two (2) years directly related and progressively responsible experience in a healthcare related to directly verifying health benefits insurance. Strong health benefits verification skills including major medical and pharmacy benefits. Knowledge of Medicare, B, D and C and Medicaid plans is preferred.

  • Ability to communicate effectively both orally and in writing
  • Adept at handling sensitive and confidential situations
  • Strong interpersonal skills
  • Excellent presentation skills
  • Strong analytical skills
  • Strong organizational skills; attention to detail
  • Ability to resolve associate issues quickly and efficiently
  • Ability to represent a positive and professional image
  • Strong knowledge of Microsoft Word, Excel, Power Point and Outlook
  • Ability to resolve PBM claim rejection


A little about us:
Where knowledge, reach and partnership shape healthcare delivery.

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