Welcome page Returning Candidate? Log back in! Benefit Verification Coordinator Job Locations US-KY-Louisville Job ID 2024-5462 Category Customer Service/Support Overview

 

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Join the KnipperHEALTH Team!

 

 

KnipperHealth is a highly profitable, rapidly growing company that is competitively unique and nimble in service solutions. We offer incredibly competitive pay and benefits that start on your first day of employment.

 

Things you can expect within your first 90 days:Zero time waiting for benefitsWelcoming team with a great cultureClassroom and on-the-job training30/60/90 check-ins with leadership teamEducational Assistance OpportunitiesToll allowance for hourly positions Interested in starting  a career in pharmacy with Knipper Health? Ask us about our company-sponsored Pharmacy Technician programs to become licensed in your state.

 

POSITION SUMMARY:

The Benefit Verification Coordinator is responsible for the coordination and processing of patient medication orders, to include order intake within regulatory boundaries, customer service coordination, and pharmacy technician duties as defined by policy and regulation and while under the supervision of a pharmacist.

Responsibilities

RESPONSIBILITIES:

Provide high quality customer service to patients and prescribers while protecting patient confidentiality.Verify information on prescriptions received prior to processing (correct prescriber, name of patient, patient information, medication, dose, quantity, number of refills).Effectively use our internal pharmacy management software, PrimeRx, to complete claims processing and prior authorizations.Perform patient level benefits verifications as applicable for all pharmacy benefits plans. Complete prior authorization templates per payer requirements to ensure medication orders will be covered by insurance plans.Evaluate all completed prior authorizations to ensure that the appropriate information has been obtained to allow for reimbursement as well as compliance with applicable standards and regulations.Processing of prior authorization responses via CoverMyMeds and submitting appeals if requested by patient/prescriber. Communicate as necessary with patients to determine general health status, medication compliance, medication and supply inventory, and overall coordination of care and service (custom assessment in software system) as applicable.Make outbound calls to prescribers, patients, and insurance companies. Assist with inbound calls as needed for respective program(s). Perform follow up on all outstanding prior authorizations/orders while following program specific correspondence for patient/prescriber/insurance. Adhere to program specific rules and timelines when processing orders. Prepare and maintain patient profile, medication administration records, and other documents as needed when setting up orders for shipment.Perform all other duties as assigned.

 

The above duties are meant to be representative of the position and not all-inclusive.

Qualifications

MINIMUM JOB REQUIREMENTS:

High School diploma or equivalentTwo (2) years of experience providing customer service to internal and external customers, including meeting quality standards for servicesRegistered and licensed pharmacy technician by the Kentucky and/or Indiana Board of Pharmacy in good standing or ability to obtain license during onboarding. Advance knowledge of medical terminology (including sig codes and Roman numerals), brand and generic names of medications, and general pharmacy terminologyAbility to read, write, speak, and understand the English language

PREFERRED EDUCATION AND EXPERIENCE:

6 months customer service experience, payer benefits experience with reimbursement and prior authorizations, healthcare industry experience, license, or equivalent coursework. Nationally certified through the PTCB or another approved certifying agencyExperience with HIPAA and patient servicesKnowledge of insurance procedures

 

KNOWLEDGE, SKILLS & ABILITIES:

Excellent organization skills and detail orientedDemonstrated empathy and compassionExcellent verbal and written communication skillsBalance multiple priorities to meet expected response deadlinesAdaptable, flexible, and readily adjust to changing situationsAbility to work independently and as a member of a teamAbility to comprehend and apply basic math principlesAbility to apply logical thinking when evaluating practical problemsAbility to present information and respond to questions from stakeholdersAbility to interact with a diverse groupAbility to listen and demonstrate a high degree of empathyDemonstrated computer skills includes Microsoft Word, Excel, and OutlookDisplay tact and diplomacy in response to unfavorable or negative situationsDemonstrated sensitivity and understanding when speaking with patientsDemonstrated passion for speaking with people in an outgoing way

 

PHYSICAL DEMANDS:

Location of job activities 100% insideNoise and / or vibrations exposureWhile performing the duties of this job, the employee is regularly required to talk or hearStand and sit for prolonged periods of timeThis job operates in a professional office environment that uses standard office equipment such as computers, phones, and printers

 

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

 

 

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