Pharmacy Services Coordinator I

Cancer Center of South Florida; West Palm Beach (FL); On-site; USD 42,000 - 56,000; Full time

Job summary

Cancer Center of South Florida is seeking a Tier I Pharmacy Services Coordinator to verify insurance benefits for oncology treatments and confirm coverage. You will manage referrals, ensure timely processing, and maintain EMR records for prior authorizations and verifications.

The role involves communicating with patients about insurance status and out-of-pocket costs, while identifying financial assistance cases and escalating as needed.

Qualifications

• Experience in medical insurance verification and prior authorization is preferred.
• Oncology or infusion therapy experience is strongly preferred.
• Familiarity with EMR systems and revenue cycle operations preferred.

Responsibilities

• Verify insurance benefits to confirm coverage for oncology treatments.
• Coordinate and manage patient referrals to specialists with timely processing.
• Upload treatment documentation into the EMR for CCSF and TGH Revenue Cycle teams.
• Communicate with patients about insurance status and out-of-pocket costs.
• Maintain accurate records in the EMR for all authorizations and verifications.
• Identify cases needing financial assistance and escalate as needed.
• Support departmental goals and meet turnaround times.

Skills

Insurance verification

Prior authorization

EMR proficiency

Revenue cycle knowledge

Oncology terminology

Education

High school diploma or equivalent

Associate degree in healthcare or related field (preferred)

Job description

Position Summary

The Tier I Pharmacy Services Coordinator is responsible for verifying insurance benefits for oncology treatments and confirming coverage. This role includes managing patient referrals to specialists, ensuring timely processing, and maintaining accurate records in the EMR for all prior authorizations and benefit verifications. The specialist communicates with patients about their insurance status, coverage requirements, and out-of-pocket costs, while identifying cases requiring financial assistance and escalating as necessary. The position also involves supporting departmental goals by completing tasks accurately and meeting turnaround time expectations.

Description

Position Summary

The Tier I Pharmacy Services Coordinator is responsible for verifying insurance benefits for oncology treatments and confirming coverage. This role includes managing patient referrals to specialists, ensuring timely processing, and maintaining accurate records in the EMR for all prior authorizations and benefit verifications. The specialist communicates with patients about their insurance status, coverage requirements, and out-of-pocket costs, while identifying cases requiring financial assistance and escalating as necessary. The position also involves supporting departmental goals by completing tasks accurately and meeting turnaround time expectations.

Core Essential Responsibilities

• Verify insurance benefits for prescribed oncology treatments to confirm coverage under the medical benefit.
• Coordinate and manage patient referrals to specialists, ensuring timely processing and communication with providers when applicable.
• Upload complete treatment documentation packets into the electronic medical record (EMR) for CCSF and TGH Revenue Cycle teams.
• Communicate with patients about insurance status, coverage requirements, and out-of-pocket costs.
• Maintain accurate, up-to-date records in the EMR for all prior authorizations and benefit verifications.
• Identify cases needing financial assistance and elevate to appropriate staff or programs as needed.
• Support departmental goals by completing assignments accurately and meeting turnaround time expectations.

Requirements

Required Education & Experience

• High school diploma or equivalent required; associate degree in healthcare or related field preferred.
• Minimum of 2 years experience in medical insurance verification, prior authorization, or related healthcare administrative role preferred.
• Experience in oncology or infusion therapy settings is strongly preferred.

Required Certificates, License Or Registration

• None

Required Knowledge, Skills Or Abilities

• Working knowledge of insurance verification processes, medical benefits, and prior authorization workflows preferred
• Familiarity with oncology treatment terminology, infusion therapies, and related clinical documentation preferred.
• Proficiency in electronic medical records (EMR) systems and basic understanding of revenue cycle operations preferred.