CSI Referral Coordinator (H)

CSI Pharmacy, LLC; Plano (TX); On-site; USD 36,000 - 39,000; Full time

Job summary

CSI Pharmacy, LLC is seeking a Referral Coordinator to gather and communicate patient and referring provider information, obtain prior authorizations, and process pre-certifications. This on-site role in Plano, TX runs Monday–Friday, 8:30am–5:00pm CST, with compensation of $26–$28/hr.

The position requires 2+ years of relevant experience and a Pharmacy Technician License within 90 days. Home infusion experience is a plus, as are strong customer service and payor knowledge skills.

Qualifications

• Minimum 2 years of relevant experience.
• Pharmacy Technician License to be obtained within 90 days of start date.
• Specialty Home infusion experience preferred (IVIG / SCIG / Biologics) but not required.
• General knowledge/experience with pharmacy payors is preferred.
• Strong customer service and communication skills are required.
• Ability to multitask in a high demand environment.

Responsibilities

• Coordinate the authorization and pre-cert process for each assigned referral.
• Follow up on referrals receipt.
• Process referrals for requested services, ensuring timely and thorough completion.
• Monitor referral requests for completeness and obtain additional information as needed.
• Enter referral/authorization data into the electronic medical record accurately.
• Send complete information to patient’s insurance and referring specialist to coordinate referral.
• Handle calls in a friendly, courteous, and sensitive manner.
• Collaborate with clinical staff, sales, and insurance teams.
• Ensure referrals are completed timely and per guidelines.
• Reach out to insurers, patients, specialists, and care teams as per guidelines.
• Comply with company policies and directives to maximize profitability.
• Complete and submit required reports promptly.
• Maintain current files and records as required.
• Provide high quality services to home-care patients and referral sources.
• Represent the company professionally and maintain good relationships.

Skills

Customer service

Multitasking

Effective communication

Payor knowledge

Education

Pharmacy Technician License

Job description

Summary

The Referral Coordinator gathers and communicates all relative information and preparation instructions to patient and referring providers. The Referral Coordinator will obtain prior authorizations, complete benefit request and process pre-certs.

Location: Plano, TX Schedule: Monday - Friday; 8:30am - 5:00pm CST (100% On-Site)

Compensation: $26 - $28/hr

Essential Duties and Responsibilities

include the following. Other duties may be assigned, as necessary.

• Coordinates the authorization and pre-cert process for each assigned referral.
• Follows up on referrals receipt
• Processes referrals for requested services, ensuring timely and thorough completion.
• Monitors referral request for completeness and takes appropriate steps to review, request and obtain additional information when requested services are incomplete or inconsistent with scope of service.
• Provides accurate data entry of referral or authorization information into the electronic medical record.
• Sends complete information to patient’s insurance (when applicable) and referring specialist to coordinate referral.
• Handles telephone calls in a friendly, courteous, and sensitive manner.
• Interacts collaboratively with clinical staff, sales team, and insurance team.
• Ensures referral is completed according to the department guidelines and within the appropriate timeframe.
• Makes outreach efforts to insurances, patients, specialist offices and care team as set forth by department guidelines and clinical priorities.
• Complies with all company policies, instructions, and directives for the fulfillment of company objectives and maximum profitable sales.
• Completes and submits all required reports in a timely manner.
• Maintains current files and other records in accordance with company instructions and requirements.
• Provides high quality services to the home-care patient and the home-care referral source.
• Consistently represents the company in a professional manner.
• Maintains effective working relationships and cooperates with all personnel in the company.
• Adheres to the company’s compliance requirements as stated in the policy and procedure manual and all other related policies.
• Performs other duties and responsibilities as assigned.

Qualification Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Provide the highest level of professionalism, responsiveness, and communication in order to build and maintain the maximum customer base possible.
• Must possess the ability to multi-task and frequently change direction.

Education and/or Experience

• 2yrs+ of relevant experience required
• Must obtain Pharmacy Technician License w/in 90 days of start date
• Specialty Home infusion experience preferred (IVIG / SCIG / Biologics) but not required
• General knowledge/experience with pharmacy payors and medical payors is preferred
• Strong customer service and communication skills are required
• Ability to multitask in a high demand environment is required

Physical Demands

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 regularly required to talk or hear. The employee regularly is required to stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

The employee frequently lifts and/or moves up to 20 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This job generally operates in a clerical office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. While performing the duties of this position, the employee may travel by automobile and be exposed to changing weather conditions.

Comments

This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time.

NOTICE: Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana.

By supplying your phone number, you agree to receive communication via phone or text.

By submitting your application, you are confirming that you are legally authorized to work in the United States.

NOTICE: Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana.

By supplying your phone number, you agree to receive communication via phone or text.

By submitting your application, you are confirming that you are legally authorized to work in the United States.

JR# JR259014