Reimbursement Specialist

University Health System; San Antonio; Presencial; CLP 37.140.000 - 46.426.000; Jornada completa

Descripción de la vacante

A healthcare organization is looking for a Pharmacy Technician to enroll indigent patients in drug assistance programs and monitor their eligibility status. The candidate should have Texas State Board of Pharmacy registration and relevant experience in the medical field. Responsibilities include communicating with various stakeholders and resolving insurance denials. This position requires strong analytical and interpersonal skills.

Formación

• Three years experience in a medical or pharmacology-related field.
• Experience with project coordination and database management.
• Demonstrated independent judgment required.

Responsabilidades

• Enroll indigent patients into drug assistance programs.
• Monitor eligibility status and document drug shipments.
• Facilitate resolution of insurance denials.

Conocimientos

Problem-solving ability

Interpersonal communication skills

Analytical skills

Independent work

Educación

Texas State Board of Pharmacy registration

National Certification as a Certified Pharmacy Technician (CPhT)

Herramientas

Computer software for tracking

Descripción del empleo

POSITION SUMMARY/RESPONSIBILITIES

Identifies and enrolls indigent and under-insured patients into drug assistance reimbursement programs which provide drug replacement and reimbursement compensation.
Monitors contain eligibility status and document drug shipments received through a computerized tracking system.
Serves as a resource in facilitating resolution of insurance denial referrals.
Communicates effectively with pharmacy, hospital administration, medical staff, patients and personnel in the patient assistance programs using verbal and written interpersonal communication skills.
Requires the ability to work independently and coordinate assigned projects efficiently.
Effectively utilizes problem-solving ability, significant interpersonal contact and concentration abilities, analytical skills and in-depth knowledge of computer software.
Coordinates all information regarding patients enrolled in assistance programs for drug therapies using various computer software programs.
Creates, expands and maintains computerized databases to support patient enrollment in assistance programs and tracks case-specific assistance provided in response to reimbursement denials.
Conducts patient interviews and conveys reimbursement denial potential to patients and medical staff.
Reviews all outpatient 3rd party rejections and assists the patient in resolving the problem.
Coordinates 3rd party billing, problems with eligibility, rejections, etc. with the Outpatient Pharmacy Supervisor and the Pharmacy Billing Section.

EDUCATION/EXPERIENCE

Texas State Board of Pharmacy registration required.
National Certification as a Certified Pharmacy Technician (CPhT) is recommended.
Three (3) years' experience in a medical or pharmacology-related field to include project coordination; database/spreadsheet development and management; and/or application programming; processing and overseeing medical insurance billing and reimbursement cost capture.
Must have demonstrated independent judgment.