Specialty Pharmacy Account Coordinator

About the role

Find your calling at Mercy! 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
• Knowledge of assistance programs (drug copay cards, foundations) and patient enrollment assistance
• Monitoring services rendered and billing assistance programs for applicable funds
• Understanding of programs, funding guidelines, claims procedures, insurance company regulations, oncology coding and billing
• Monitoring insurance company regulations for changes in pre-certification, documentation, medical necessity criteria, policy requirements, claims submission requirements
• Communicating with physicians, staff, patients, and insurance companies
• Serving as a resource for other staff and patients
• Acting as Senior Pharmacy Technician as needed
• Performing duties consistent with Mercy Service Standards

Requirements

• Some college hours in Business, Finance, and/or Accounting related courses preferred
• Current State Technician license in good standing
• Minimum of 3 years related experience, including 1 year of relevant pharmacy experience
• Certified Pharmacy Technician (CPhT) by PTCB required within six months of start

Skills

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

Benefits

• Medical, dental, and vision coverage
• Paid time off
• Tuition support
• Matched retirement plans (for team members working 32+ hours per pay period)