Insurance Verification Coordinator - Specialty

CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.

Job Details:

Manage the daily functions of the Insurance Verification area including verification of insurance coverage, re-verifying coverage for existing patients, enter and update patient demographics into the computer system, and securing reimbursement related paperwork.  Support the Supervisor of Insurance Verifications with case management, price quotes, price negotiation, and spot deals. Time zone preference: CST/PST/MST.

Responsibilities  

• Work effectively and maintain expected productivity

• Verify patients' insurance benefits for therapies prior to servicing the patient

• Completes Insurance Verification Coordinator responsibilities regarding payor guidelines, contract pricing, test claims and authorizations

• Track, monitor, and secure clinical documentation, AOB's etc. based upon insurance carrier requirements.

• Create new hospital and physician codes as needed.

• Give high priority to client satisfaction and customer needs.

• Prioritizes and completes work on schedule.

• Assist in generating price quotes.

• Review benefits and financial responsibility with patient or family members when required.

• Obtain prior authorizations requirements to streamline Revenue Cycle

• Assist in price negotiation with case managers.

• Assist in researching reimbursement issues.

• Performs in accordance with system-wide competencies/behaviors

• Demonstrates ability to communicate effectively and express ideas clearly.

• Performs other duties as assigned

• Meets quality standards, shows pride in performance, and demonstrates reliability and follow-through on all assigned tasks.

Skills & Abilities

• Excellent written and verbal communication

• Organization

• Time Management

• Professional

• High Integrity

• Interpersonal skills

• Effective problem-solving skills

Requirements

• HS diploma or GED required.

• 2-4 years of experience in a healthcare setting with specific experience in business functions such as registration and insurance verification OR equivalent combination of education and experience required.

• At least 1 year of experience in home IV therapy and/or insurance verifications, preferred.

• Knowledge of medical terminology and coordination of benefits

• Capable of managing multiple priorities.

• Knowledge of payer websites is preferred.

• Knowledge of pharmacy payers and authorization requirements preferred

• Proficient computer skills and Microsoft Office Products required.

• Excellent customer service skills

CarepathRx offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire.

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.