Specialty Pharmacy Account Coordinator

The Specialty Account Coordinator I

The Specialty Account Coordinator I is responsible for multiple facets of patient account coordination including insurance/benefit verification, rejection and denials management, and collections. This role also involves knowing which assistance programs patients may qualify for, assisting them in enrolling, and monitoring services rendered and billing the assistance programs for applicable funds. The position requires a thorough understanding of available programs, funding guidelines, claims procedures, and insurance company regulations, as well as oncology coding and billing. It also involves monitoring insurance company regulations for changes in pre-certification, documentation, medical necessity criteria, policy requirements, and/or claims submission requirements.

• Knowledge of oncology coding and billing
• Understanding of insurance company regulations and policies
• Ability to communicate effectively with physicians, staff, patients, and insurance companies
• Ability to work in stressful situations and meet deadlines
• Ability to provide good written and oral direction to co-workers
• Ability to work effectively with VBO management and co-workers in demanding situations

Education and Experience

Some college hours in Business, Finance, and/or Accounting related courses are preferred. A minimum of 3 years related experience is required, including 1 year of relevant pharmacy experience. A Certified Pharmacy Technician (CPhT) certification by the Pharmacy Technician Certification Board (PTCB) is required within six months from start.

Skills and Abilities

Interpersonal, organizational, and analytical skills are required. Must possess the ability to work in stressful situations, meet deadlines, and perform daily responsibilities with consistent accuracy. Must be able to use logic, make good judgments, and quickly identify and initiate corrective actions when problems arise. Must be able to communicate effectively, providing good written and oral direction to co-workers.