Lead Pharmacy Services Coordinator (West Palm Beach)

Cancer Center of South Florida; West Palm Beach (FL); In loco; USD 70.000 - 95.000; Tempo pieno

Descrizione del lavoro

Cancer Center of South Florida is seeking a Lead Pharmacy Services Coordinator to oversee pharmacy operations, assess treatment costs, obtain insurance approvals, and counsel patients on benefits and copayments.

The role requires expertise in oncology billing and payer policies, with responsibility for pre-authorizations, cost counseling, and collaboration with physicians, nursing staff, and payers.

Competenze

• Thorough understanding of insurance verification, benefits investigation, prior authorizations, and payer policies, especially in oncology settings.
• Proficiency in medical billing systems and knowledge of financial assistance programs, co-pay cards, and patient reimbursement processes.
• Strong communication, counseling, and customer service skills to explain financial responsibilities to patients.

Mansioni

• Lead and support Pharmacy team operations, including training, scheduling, and task oversight.
• Review and assess IV therapy orders using clinical documentation, payer guidelines, drug cost, and reimbursement data.
• Recommend billing strategies based on financial and payer assessments.
• Obtain and document pre-authorizations for treatments and upload documentation to the EMR.
• Communicate with patients and insurers regarding pre-certification and coverage questions.
• Determine insurance coverage and patient financial responsibility for chemotherapy and therapeutic protocols.
• Provide patient cost estimates for upfront collections and coordinate financial assistance efforts.

Conoscenze

Insurance verification

Financial counseling

Patient billing

Formazione

Healthcare administration or business degree

High school diploma or equivalent

Descrizione del lavoro

POSITION SUMMARY:

The Lead Pharmacy Services Coordinator is responsible for clinical and financial assessment of physician prescribed treatments including, but not limited to chemotherapy, immunotherapy, supportive IV therapy, and other oncology-related therapy. The Lead Pharmacy Services Coordinator obtains insurance approvals, counsels the patient on insurance benefits and copayments. This position is in constant communication with patients, physicians, nursing staff, and third-party payers, wholesalers, and other team members.

CORE ESSENTIAL RESPONSIBILITIES:

• Lead and support Pharmacy team operations, including training, scheduling, and task oversight.
• Review and assess IV therapy orders using clinical documentation, payer guidelines, drug cost, and reimbursement data.
• Recommend billing strategies (e.g., white bagging vs. buy & bill) based on financial and payer assessments.
• Obtain and document pre-authorizations for treatments and upload related documentation to the electronic medical record.
• Communicate with patients and insurers regarding the pre-certification process and coverage questions.
• Determine insurance coverage and patient financial responsibility for chemotherapy and therapeutic protocols.
• Provide patient cost estimates for upfront collections (copays, deductibles, and coinsurance) and coordinate financial assistance efforts, including counseling appointments, enrollment tracking, and compassionate use requests.

REQUIRED EDUCATION & EXPERIENCE:

• High school diploma or equivalent required; Associate's or Bachelor's degree in healthcare administration, business, or related field preferred.
• Minimum of 3 years of experience in patient financial counseling, insurance verification, or revenue cycle management in a healthcare setting preferred.
• Experience with oncology billing, pharmacy benefits, or financial assistance programs strongly preferred.

REQUIRED CERTIFICATES, LICENSE OR REGISTRATION:

• None

REQUIRED KNOWLEDGE, SKILLS OR ABILITIES:

• Thorough understanding of insurance verification, benefits investigation, prior authorizations, and payer policies, especially in oncology settings.
• Proficiency in medical billing systems (e.g., EPIC, Atlas) and knowledge of financial assistance programs, co-pay cards, and patient reimbursement processes.
• Strong communication, counseling, and customer service skills to explain financial responsibilities and support patients navigating complex treatment costs.