Openings >> Benefit Verification Coordinator_8590
Benefit Verification Coordinator_8590
Title:Benefit Verification Coordinator_8590
Labor Type:Contract
Posting #:8590
Location:Frisco TX
5 months contact

.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. 

• 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. 

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
This opening is closed and is no longer accepting applications
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