Pharmacy Benefits Coordinator

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Job Type

Full-time

Description

Pharmacy Benefits Coordinator

We offer competitive salary, benefits (including medical, dental, vision), retirement, PTO, and recognize 9 paid holidays.

If you are a compassionate professional who provides exceptional quality care, Jordan Valley is for you! We are Missouri's largest Federally Qualified Health Center founded in 2003 and we serve 75,000 patients each year. The mission of Jordan Valley is to improve the health of our community by providing high-quality and accessible medical, dental, and behavioral health services to Southwest MO. We're collaborative and believe in always going above and beyond as part of our commitment to deliver excellent care to our community!

Job Overview:

The Pharmacy Benefits Coordinator is responsible for performing tasks related to the management of third-party billing for patients served by the outpatient pharmacies. Responsibilities include serving as a liaison between billing operations and medical staff, to ensure effective communication regarding billing issues.

Duties:

• Review and screen new patients at intake to determine patient needs.

• Refer appropriate patients to financial counseling for coverage or charity application.

• Provide monthly adherence phone calls to patients.

• Function as primary third-party resource for outpatient pharmacy staff.

• Resolve billing rejections and subsequently rebill claims to appropriate carrier for all commercial, federal, and state insurance plans. Submit prior authorization requests, follow up on submitted prior authorization requests and submit claims with approvals as appropriate.

• Ensure all required documentation for billing is completed and accurate prior claim submission.

• Identify patients who may quality for patients medication assistance programs or copay assistance

• Establish and maintain good working relationships with billing operations specialists and outpatient clinic pharmacy staff to maintain effective communication regarding third-party billing issues.

• Assist in the development, implementation, and evaluation of third-party billing policies and procedure.

• Educate pharmacy staff about third-party billing policies and procedure as needed.

• Maintains subject matter expertise pertaining to all external billing practices including but not limited to third party adjudications, prior authorization, and patient financial assistance programs to coach pharmacy technicians and other support staff.

Benefits

Our benefits are designed to encourage a healthy work-life balance.

• Health (Both HSA and FSA options and access to our Telemedicine program)

• Vision

• Free dental and life insurance, and long term disability. Affordable rates for family dental and life insurance.

• 403b retirement match on the 1st of the month after 30 days.

• Employee Assistance Program

• Day One PTO Accrual

• 9 Paid Holidays

• Free On Site Fitness Facility at our Springfield Tampa Clinic

Requirements

Required Qualifications:

• High School Diploma or equivalent.

• Pharmacy technician license, in states where required.

• Maintains PTCB or ExCPT certification through the designated PTCB or ExCPT training program and/or state required certification/registration.