Ambulatory Pharmacy Representative

PeaceHealth; Bellingham (WA); On-site; USD 30,000 - 45,000; Full time

Job summary

PeaceHealth is seeking an Ambulatory Pharmacy Representative for a full-time, 1.00 FTE, day position in Washington state. The role supports scheduling, insurance verification, and pre-certification for ambulatory pharmacy visits, ensuring efficient departmental operations.

The position requires a minimum of 1 year in medical office or related customer service experience, with knowledge of insurance processes and CPT/ICD-10 coding preferred.

Qualifications

• High School Diploma preferred.
• Minimum of 1 year medical office or related customer service experience.
• Experience with Microsoft Office applications (Word, Excel and Outlook) preferred.
• Experience with ambulatory pharmacy services preferred.
• Demonstrated knowledge of Medical Terminology and CPT/ICD-10 coding (Preferred).
• Ability to work efficiently and responsibly in an environment with multiple demands, interruptions and time frames, with minimal supervision (Required).
• Advanced problem-solving and critical thinking skills that demonstrate positive outcomes (Required).
• Knowledge of insurance process and regulations (Preferred).
• Must be able to manage conflict effectively and professionally (Required).
• Excellent time management skills, with an emphasis on meeting time sensitive deadlines (Required).
• Good customer service skills and good interpersonal skills (Required).

Responsibilities

• Pre-registers/registers patients with accurate patient demographic, financial data.
• Receives incoming phone calls related to scheduling and coordination of patients and resources.
• Collects and evaluates patient demographic, insurance, clinical, and non-clinical information.
• Collects balances, co-payment, co-insurance, or other payment types over the phone.
• Verifies coverage and ensures all insurance requirements are met, as well as obtaining all prior authorization and/or referrals as appropriate prior to patient arrival.
• Responds to customer’s inquiries about ambulatory pharmacy services.
• Manages daily ambulatory pharmacy service appointment schedules.
• Identifies inaccuracies and missing data that would affect department’s financial results; monitors cancellations and rescheduling of appointments to manage schedules, identifies potential resource conflicts and works with leadership to resolve them.
• Obtains required paperwork and/or electronic form for chart completion, ensures orders, history, and physical, and consents are complete.
• Performs other duties as assigned.

Skills

Customer service

Communication

Time management

Problem solving

Insurance knowledge

Education

High School Diploma

Tools

Microsoft Office

Outlook

Word

Excel

Job description

Job Description

PeaceHealth is seeking a Ambulatory Pharmacy Representative for a Full Time, 1.00 FTE, Day position.

The salary range for this job opening at PeaceHealth is $21.59 – $32.39.

The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.

Job Summary

Supports the Ambulatory Pharmacy Department by coordinating the activities between scheduling, insurance verification, and pre-certification for pharmacy service visits. Coordinates efficient operation of the department by completing support activities as assigned.

Essential Functions

• Pre-registers/registers patients with accurate patient demographic, financial data.
• Receives incoming phone calls related to all aspects of scheduling and coordination of patients and resources.
• Collects and evaluates patient demographic, insurance, clinical, and non-clinical information.
• Collects balances, co-payment, co-insurance, or other payment types over the phone.
• Verifies coverage and ensures all insurance requirements are met, as well as obtaining all prior authorization and/or referrals as appropriate prior to patient arrival.
• Responds to customer’s inquiries about ambulatory pharmacy services.
• Manages daily ambulatory pharmacy service appointment schedules.
• Identifies inaccuracies and missing data that would affect departments’ financial results; monitors cancellation and rescheduling of appointments to manage schedules, identifies potential resource conflicts and works with leadership to resolve them.
• Obtains required paperwork and/or electronic form for chart completion, ensures orders, history, and physical, and consents are complete.
• Performs other duties as assigned.
• Performs other duties as assigned.

Qualifications

• High School Diploma Preferred:
• Minimum of 1 year Required: Medical Office or related customer service experience and
• Preferred: Experience with Microsoft Office applications, including Word, Excel and Outlook and
• Preferred: Experience with ambulatory pharmacy services
• Demonstrated knowledge of Medical Terminology and CPT/ICD-10 coding. (Preferred)
• Must have the ability to work efficiently and responsibility in an environment with multiple demands, interruptions and time frames, with minimal supervision. (Required)
• Advanced problem-solving and critical thinking skills that demonstrate positive outcomes. (Required)
• Knowledge of insurance process and regulations. (Preferred)
• Must be able to manage conflict effectively and professionally. (Required)
• Excellent time management skills, with an emphasis on meeting time sensitive deadlines. (Required)
• Good customer service skills and good interpersonal skills. (Required)

Working Conditions

• Consistently operates computer and other office equipment.
• Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.
• Sedentary work.
• Predominantly operates in an office environment.
• Ability to communicate and exchange accurate information.
• The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.

PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.

EEO Aff…