Specialty Pharm Account Coordinator

About the role

The Specialty Account Coordinator I is responsible for multiple facets of patient account coordination including insurance/benefit verification, rejection and denials management and collections. The Specialty Account Coordinator is also responsible for knowing which assistance programs, such as drug copay cards and/or foundations, patients may qualify for, assisting patients in enrolling in those programs, monitoring services rendered and billing the assistance programs for the applicable funds. This position requires a thorough understanding of all available programs, funding guidelines, claims procedures and insurance company regulations, as well as oncology coding and billing. This position monitors insurance company regulations for changes in pre-certification, documentation, medical necessity criteria, policy requirements and/or claims submission requirements. This position requires accuracy, attention to detail and the ability to communicate well with physicians, staff, patients, and insurance companies. The Specialty Account Coordinator I serves as a resource for other staff and patients. This position serves as a Senior Pharmacy Technician as needed. Performs duties in a manner consistent with Mercy Service Standards.

Responsibilities

• Insurance/benefit verification
• Rejection and denials management
• Collections
• Knowing which assistance programs (drug copay cards, foundations) patients may qualify for
• Assisting patients in enrolling in assistance programs
• Monitoring services rendered
• Billing assistance programs for applicable funds
• Maintaining thorough understanding of available programs, funding guidelines, claims procedures, insurance company regulations, and oncology coding and billing
• Monitoring insurance company regulations for changes in pre‑certification, documentation, medical necessity criteria, policy requirements, and claims submission requirements
• Ensuring accuracy, attention to detail, and effective communication with physicians, staff, patients, and insurance companies
• Serving as a resource for other staff and patients
• Functioning as a Senior Pharmacy Technician as needed
• Performing duties consistent with Mercy Service Standards

Requirements

• A minimum of 3 years related experience required including 1 year of relevant pharmacy experience.

Qualifications

• Some college hours in Business, Finance and/or Accounting related courses preferred.
• Current State Technician license in good standing.
• Certified Pharmacy Technician (CPhT) by the Pharmacy Technician Certification Board (PTCB) required within six months from start.

Skills

• Interpersonal, organizational, and analytical skills required.
• Ability to work in stressful situations, meet deadlines, and perform daily responsibilities with consistent accuracy.
• Ability to use logic, good judgment and be able to rapidly identify and initiate corrective actions when problems arise.
• Ability to communicate effectively providing good written and oral direction to co‑workers.
• Ability to work effectively with VBO management and co‑workers in demanding situations.

Benefits

From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period. Join a caring, collaborative team where your voice matters. At Mercy, you'll help shape the future of healthcare through innovation, technology, and compassion. As we grow, you'll grow with us.