Enhanced Benefits Coordinator Augusta

Wellstar Health System; Augusta (GA); On-site; USD 38,000 - 52,000; Full time

Job summary

Wellstar Health System in Georgia seeks an Enhanced Benefits Coordinator to serve as the hub for prior authorizations across key service lines. You will obtain and validate insurance and financial information, secure precertifications, and provide benefits overviews to patients before treatment.

The role involves front-line contact with patients, families, providers, nurses and pharmacies, coordinating with medication assistance programs and pharmacy benefits to ensure timely delivery.

Qualifications

• High school diploma or GED required; bachelor's degree preferred.
• Pharmacy technician license (PHT) required.
• 1+ year Pharmacy Technician experience in enhanced benefits or medical office.
• 2+ years Pharmacy Technician experience preferred in enhanced benefits or medical office.

Responsibilities

• Screens, processes, and completes prior authorization through medical benefits and pharmacy benefits.
• Follows-up with patients, providers, and insurance plans on refills and reauthorizations.
• Processes infusion/injection appointments through WMCG IT platforms.
• Coordinates with Medication Assistance Coordinators for specialty medications and shipping related to patient medications.
• Collaborates with Pharmacy Department for performance improvement, customer service, and quality assurance.
• Performs other duties as assigned
• Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Skills

Communication

Organizational skills

Prioritization

Time management

Medical terminology

Insurance claims

Prior authorizations

Education

High School Diploma / GED

Bachelor's degree preferred

Tools

Microsoft Office

Job description

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Work Shift

Various (United States of America)

Job Summary

The Enhanced Benefits Coordinator serves as the hub for prior authorizations associated with key service lines within the medical center as well as health system clinics. This position will obtain and validate insurance and financial information, obtain any required precertification and/or prior authorization for in office administered medications, and provide benefits overviews to patient prior to treatment. This position is responsible for providing front line, direct contact with patients, families, providers, nurses, social workers and pharmacies.

Core Responsibilities and Essential Functions

• Screens, processes, and completes prior authorization through medical benefits and pharmacy benefits.
• Follows-up with patients, providers, and insurance plans on refills and reauthorizations, as required by payers.
• Processes infusion/injection appointments through WMCG IT platforms in an accurate manner.
• Coordinates with Medication Assistance Coordinators for specialty medications filled through pharmacy benefits or medications accessed through assistance programs. Coordinates shipping activities associated with patients own medication to ensure accurate and timely medication delivery.
• Collaborates with other members of the Pharmacy Department team for performance improvement, customer service excellence, and quality assurance (teamwork).
• Performs other duties as assigned
• Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education

• High School Diploma / GED General or Bachelors General-Preferred

Required Minimum License(s) and Certification(s)

All certifications are required upon hire unless otherwise stated.

• PHT - Registered Pharmacy Tech

Required Minimum Experience

• Minimum 1 year Pharmacy Technician role or in enhanced benefits or similar role in medical office/center, Pharmacy required
• Minimum 2 years Pharmacy Technician role or in enhanced benefits or similar role in medical office/center, Pharmacy preferred

Required Minimum Skills

• communication skills, organizational skills, prioritization, time management.
• Microsoft Office proficiency
• Proficient with medical terminology
• Experience with prior authorizations, insurance, claim adjudication and claim appeals.- Preferred

Join us and discover the support to do more meaningful work-and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.