Insurance Coordinator - Specialty Pharmacy
Insurance Coordinator - Specialty Pharmacy
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$ 23 - 28
1 Vacancy
Job Description
About AmeriPharma
AmeriPharma is a rapidly growing healthcare company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas creativity and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves.
AmeriPharmas Benefits
- Full benefits package including medical dental vision life that fits your lifestyle and goals
- Great pay and general compensation structures
- Employee assistance program to assist with mental health legal questions financial counseling etc.
- Comprehensive PTO and sick leave options
- 401k program
- Plenty of opportunities for growth and advancement
- Company sponsored outings and teambuilding events
- Casual Fridays
Job Summary
As an Insurance Coordinator at AmeriPharma you will be responsible for accurate and timely verifications of patients medical insurance coverage and securing medical prior authorization to allow for appropriate and prompt payment of services.
Schedule Details
- InPerson (Laguna Hills Ca)
- Monday to Friday 8:30 AM to 5:00 PM. The first two months of training may be scheduled from 7:30 AM to 4:00 PM to be confirmed.
Duties and Responsibilities
- Verify and prioritize orders needing benefits investigation and medical prior authorization.
- Review and ensure insurance information is complete in patient profiles.
- Contact insurance companies to verify coverage details including plan type coverage limits deductibles exclusions and service requirements.
- Document all communications with insurance companies including representatives names phone numbers and reference numbers.
- Inform patients providers and team members about plan restrictions exclusions and reimbursement issues.
- Assist with financial documents like Financial Obligation Notifications and Medicare Advance Beneficiary Notifications (ABN).
- Coordinate patient enrollment in copay programs and review cases needing clinical judgment.
- Submit and follow up on prior authorization requests with insurance plans.
- Handle inbound calls from patients providers and other departments regarding medical authorization status.
- Track patient coverage changes and coordinate with billers to ensure service continuity.
- Resolve escalated inquiries and provide subject matter expertise on benefits investigations and authorization processes.
- Use reports and reminders to track pending activities and ensure timely completion.
- Maintain caseload and ensure all tasks are completed within deadlines.
- Provide excellent customer service when interacting with patients providers and colleagues.
- Ensure compliance with payer rules company policies and processes.
- Perform other duties as assigned.
Required Skill Qualifications
- Proficient in English (reading writing speaking).
- Ability to collaborate with team members and management.
- Strong time management communication and interpersonal skills.
- Attention to detail with minimal typing errors.
- Ability to work independently and meet deadlines.
- Familiar with medical coding and insurance terminology (ICD10 CPT HCPCS).
- Experience with managed care Medicare Medicaid and insurance reimbursement.
- Advanced skills in Microsoft Word Excel and Outlook.
- Ability to analyze and interpret data effectively.
Education Requirements
- High School Diploma
- Experience as a medical coder/biller with a working knowledge of managed care commercial
insurance Medicare and Medicaid reimbursement required. - Knowledge of ICD 10 CPT HCPC and J billing codes and medical terminology with CMS HCFA 1500
form & Electronic Billing. - Knowledge of Benefit Investigation and Patient Responsibility Agreements.
- Knowledge of automated billing systems.
- Advanced knowledge of Word Excel and Outlook functions.
Preferred Skills and Experience
- Microsoft Office/Excel: 1 year
- 1 year of Pharmacy experience
- Experience with CPR
AmeriPharmas Mission Statement
Our goal is to achieve superior clinical and economic outcomes while maintaining the utmost compassion and care for our patients. It is our joint and individual responsibility daily to demonstrate to outpatients prescribers colleagues and others that We Care!
Physical Requirements
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job the employee is continuously required to sit and talk or hear. The employee is occasionally required to stand; walk; use hands to finger handle or feel objects tools or controls; reach with hands and arms; and stoop kneel crouch or crawl. The employee must regularly lift and/or move up to 20 pounds and occasionally lift/or move up to 30 pounds. Specific vision abilities required by this job include close vision peripheral vision depth perception and the ability to adjust focus.
EEO Statement
The above statements are intended to describe the work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities duties and skills required. The duties and responsibilities of this position are subject to change and other duties may be assigned or removed at any time. AmeriPharma values diversity in its workforce and is proud to be an AAP/EEO qualified applicants will receive consideration for employment without regard to race sex color religion sexual orientation gender identity national origin age protected veteran status or based on disability or any other legally protected class.
Required Experience:
Manager
Employment Type
Full-Time
