Clinical Success Team Technician

Symbria Rx Services is seeking a team oriented. As one of the few100 employeeownedcompanies inhealthcare our business practices are guided strictly by the values to which our employee owners are committed to. For more than 20 yearsSymbriahas been providing an outstanding work environment for talented employees to deliver patientcentered care to the geriatric population in seniorliving and postacute settings.

TheLTC Pharmacy Adjudicatoris responsible for communicating to the communities when order exceptions occur such as nonformulary expensive medications and incomplete orders. This position works closely with the community staff to have orders clarified and medications changed to less expensive alternatives. Coordinates all adjudication on Medicare D claims where needed and to perform all functions required to maintain update and bill customers accounts timely and accurately.

Working Schedule:

• 10:00am6:30PM MonFri and every 3rd weekend 2:30PM11PM.
• Must work holidays
• Must currently live in a state Symbria Rx Services is licensed in: AZ CO FL IL IN KS MA MI MO PA OH WI.
• 100 Remote

• Initiate communication to communities regarding expensive and nonformulary medication orders and educate on less expensive alternatives identified by staff pharmacists.
• Initiate communication to community regarding incomplete orders which require further clarification.
• Keep detailed records of all orders that require communication to the community for potential follow up if needed.
• Follow up with the community per policy timeframe if the medications have not been changed or clarified. Send another supply of medication if needed.
• Communicate professionally with community management staff including Director of Nursing and Administrator via phone or email.
• Assist with data entry of orders as needed.
• Assist with answering phone calls for the data entry department.
• Review Medicare D rejections and prior authorizations and coordinate with pharmacists or physicians to successfully adjudicate all claims.
• Work in conjunction with designated operations staff to prepare for formulary changes.
• Perform insurance and billing clerical duties including review and maintenance of patient account information.
• Prepare and submit claims to various third parties either electronically or by paper.
• Identify and resolve claim denials.
• Act as liaison between patients and third parties.
• Work collaboratively with other team members and supervisor to ensure best practices are shared.
• Provide backup support to other pharmacy departments based on business needs or production levels as needed.
• Any and all duties as assigned.

To perform this job successfully the ability to perform each essential duty satisfactorily is necessary and the qualifications listed below are representative of the knowledge skill and/or ability required:

• High School diploma or general education degree (GED).
• Pharmacy Technician License and/or Certification (CPhT) as per State requirements (must be licensed in Illinois and Massachusetts within 60 days of hire).
• Data entry experience; minimum one year.
• Excellent customer service interpersonal verbal and written communication skills.
• General computer knowledge including Microsoft Office: Word Excel and Outlook.
• Ability to maintain organization multitask and prioritize to manage assignments/projects.
• Strong knowledge of Brand/Generic and medical terminology.

QUALIFICATIONS PREFERRED
Prescription billing experience; minimum one year.

Why work for us

At Symbria our employees act like owners because we are owners! As one of the few 100 employeeowned healthcare providers our focus remains on delivering bestinclass services within our Pharmacy Rehabilitation and WellBeing operations which allows our clients to improve the lives and wellbeing of their patients and residents. Our teams utilize insights and analytics to drive better health outcomes for our partnered postacute and senior living communities while providing them with flexible service options.

Symbrias Core Values drive the way we partner with those clients their patients and residents and the way our diverse employeeowners work together:

• Integrity Honest Fairness and ethics
• Compassion Commitment to serving seniors
• Stewardship Maximizing mission and margin
• Innovation Striving to enhance our value to your organization
• Teamwork Working together unselfishly toward goals

As an employeeowner Symbrias success becomes your success. In addition we provide:

• Competitive pay aligned with market guidelines
• Full Benefits Package including very generous paid time off plans
• Professional liability coverage
• 100 employerfunded ESOP retirement plan
• 401(k) and Roth(k) plans
• Continuing education
• Credit union membership

All applicants will be afforded equal opportunity without discrimination because of race color religion sex sexual orientation marital status order of protection status national origin or ancestry citizenship status age physical or mental disability unrelated to ability military status or an unfavorable discharge from military service.


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