Enhanced Benefits Coordinator Augusta

Wellstar Health System; Grovetown (GA); On-site; USD 42,000 - 54,000; Full time

Job summary

Wellstar Health System in Grovetown, GA, is seeking an Enhanced Benefits Coordinator to manage prior authorizations for medical and pharmacy benefits, verify insurance details, and provide benefits overviews to patients before treatment. This role requires strong communication, organization, and healthcare terminology proficiency.

You will interact with patients, providers, nurses, social workers, and pharmacists, coordinating with Medication Assistance Coordinators to ensure timely medication

Qualifications

• High School Diploma or GED is required; Bachelor's degree preferred.
• PHT - Registered Pharmacy Tech certification required on hire.
• Minimum 1 year in Pharmacy Technician role or enhanced benefits in a medical office.

Responsibilities

• Screens and processes prior authorizations for medical and pharmacy benefits.
• Follow-ups with patients, providers, and insurances for refills and reauthorizations.
• Coordinate infusion/injection appointments using AU Health IT platforms.
• Collaborate with Medication Assistance Coordinators for specialty medications.
• Ensure timely medication delivery and support with department quality efforts.

Skills

Communication skills

Organizational skills

Prioritization

Time management

Microsoft Office

Medical terminology

Prior authorizations

Education

High School Diploma

Tools

AU Health IT platforms

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

Day (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 AU Health 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 General or 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.