Enhanced Benefits Coordinator WMCG

WellStar Health System; Augusta (GA); On-site; USD 40,000 - 55,000; Full time

Job summary

Join a leading healthcare provider as an Enhanced Benefits Coordinator, a pivotal role ensuring patient insurance authorizations and benefits are administered effectively. This full-time opportunity is ideal for an entry-level candidate with a high school diploma and necessary Pharmacy Technician certifications, looking to make a difference in a dynamic hospital environment.

Qualifications

• Experience as a Pharmacy Technician or in a similar benefits role (minimum of 1 year).
• Strong communication, organizational, prioritization, and time management skills.
• Proficiency in medical terminology.

Responsibilities

• Process prior authorizations for medical and pharmacy benefits.
• Coordinate with patients, providers, and insurance for medication logistics.
• Collaborate with the Pharmacy Department to enhance service quality.

Skills

Communication

Organizational Skills

Time Management

Education

High School Diploma or GED

Bachelor's Degree (preferred)

CPHT Certification

PHT Certification

Tools

Microsoft Office

Job description

Join to apply for the Enhanced Benefits Coordinator WMCG role at Wellstar Health System.

This position serves as the hub for prior authorizations related to key service lines within the medical center and clinics. Responsibilities include obtaining and validating insurance and financial information, securing precertifications and prior authorizations for medications, and providing benefits overviews to patients before treatment. The role involves direct contact with patients, families, providers, nurses, social workers, and pharmacies.

Core Responsibilities and Essential Functions

• Screen, process, and complete prior authorizations for medical and pharmacy benefits.
• Follow-up with patients, providers, and insurance plans on refills and reauthorizations.
• Process infusion/injection appointments using AU Health IT platforms.
• Coordinate with Medication Assistance Coordinators for specialty medications and assistance programs.
• Manage shipping activities for patients' medications to ensure timely delivery.
• Collaborate with the Pharmacy Department to improve performance, customer service, and quality assurance.
• Perform other duties as assigned and comply with all Wellstar policies and standards.

Minimum Education and Certifications

• High School Diploma, GED, or Bachelor's degree preferred.
• Certifications required upon hire: CPHT (Certified Pharmacy Technician), PHT (Registered Pharmacy Technician).

Experience and Skills

• At least 1 year of experience as a Pharmacy Technician or in a similar benefits role; 2 years preferred.
• Strong communication, organizational, prioritization, and time management skills.
• Proficiency in Microsoft Office and medical terminology.
• Experience with prior authorizations, insurance claims, and appeals is preferred.

Additional Details

• Seniority level: Entry level
• Employment type: Full-time
• Job function: Human Resources
• Industry: Hospitals and Healthcare