Financial Coordinator Pharmacy Specialties

Lehigh Valley Hospital, Inc.; Allentown (Lehigh County); On-site; USD 60,000 - 90,000; Full time

Job summary

Join a nationally recognized health network committed to delivering exceptional patient care. This role focuses on providing financial support for patients in the Specialty Pharmacy, enhancing their experience by alleviating financial burdens. You will work closely with clinical and financial teams to ensure optimal coverage and reimbursement for high-dollar treatments. This is an opportunity to make a meaningful impact in the lives of patients, especially the uninsured and underinsured, while being part of a compassionate and professional team dedicated to excellence in healthcare.

Qualifications

• 3+ years experience in a pharmacy setting, especially in Oncology.
• Ability to assess complex treatment scenarios and patient needs.

Responsibilities

• Review referrals to ensure optimal insurance coverage and benefits.
• Manage the Free Market Health platform for referral documentation.
• Collaborate with financial services to resolve authorization issues.

Skills

Insurance Verification

Communication Skills

Financial Assessment

Medical Terminology

Education

Bachelor’s Degree in Healthcare

Tools

Word

Excel

Scheduling/Billing Systems

Job description

Lehigh Valley Health Network (LVHN) is home to nearly 23,000 colleagues who make up our talented, vibrant and diverse workforce.

Join our team and experience firsthand what it's like to be part of a health care organization that's nationally recognized, forward-thinking and offers plenty of opportunity to do great work.

Imagine a career at one of the nation's most advanced health networks.

Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work.

LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Additionally, Lehigh Valley Hospital - Cedar Crest, Muhlenberg, Hazleton, and Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day.

Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network.

**Summary**

Responsible for global patient financial support for patients receiving services in the Specialty Pharmacy. The goal is to improve the patient experience by alleviating financial burdens, especially for uninsured and underinsured patients, through facilitating enrollment in assistance programs, while protecting hospital revenue by maximizing internal referrals and reimbursement for high-dollar treatments.

**Job Duties**

1. Review Specialty Pharmacy referrals to ensure optimal insurance coverage, including medical necessity, authorization, benefit and eligibility verification, differentiating between pharmacy and medical benefits.
2. Manage the Free Market Health (FMH) platform, including referral management and documentation.
3. Understand 340B Drug Program qualification rules to determine rate agreements.
4. Utilize external resources like pharmaceutical assistance programs, copay relief, PATH, PACE, and foundational support.
5. Leverage internal resources such as charity cards, financial assistance, and hardship programs.
6. Collaborate with financial services and pharmacy teams to resolve authorization and denial issues to maximize reimbursement.
7. Coordinate with clinical teams to ensure coverage and optimal patient outcomes.
8. Maintain current knowledge of payer requirements, policies, and regulations.

**Minimum Qualifications**

• Bachelor’s Degree in a healthcare-related field or equivalent experience.
• At least 3 years in a pharmacy setting (Oncology or similar), including coding, billing, registration, insurance verification/authorization.
• Ability to assess customer financial needs and complex treatment scenarios.
• Excellent communication skills to convey patient needs.
• Expertise in determining insurance benefits and billing requirements.
• Ability to maintain confidentiality and understand patient rights.
• Knowledge of specialized treatments and related insurance issues.
• Compassion combined with professional skills.
• Proficiency in medical terminology, Word, Excel, and scheduling/billing systems.

**Preferred Qualifications**

• 5 years of experience in a pharmacy setting (Oncology or similar).
• Knowledge of the 340B Drug Program.

**Physical Demands**

Lift and carry 25 lbs., frequent sitting/standing, keyboard use, and role-specific activities like kneeling, bending, squatting, and CPR.

Lehigh Valley Health Network is an equal opportunity employer, adhering to all applicable employment laws and policies, ensuring opportunities regardless of race, color, religion, sex, age, national origin, sexual orientation, gender identity, disability, or other protected classes.