Clinical Support Coordinator - BioPlus Specialty Pharmacy

Elevance Health•Harvey, LA

1d•Hybrid

About The Position

The Clinical Support Coordinator - BioPlus Specialty Pharmacy is responsible for participating in program management activities, supporting, and facilitating the distribution of reports and communication documents, and assisting with process improvement initiatives designed to improve customer service. BioPlus Specialty Pharmacy is a proud member of the Elevance Health family of companies. BioPlus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer’s treatment journey.

Requirements

Requires a HS diploma or equivalent and minimum of 3 years experience in a general office/administrative environment; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

Managed healthcare experience.
Experience working in a high call volume environment.
Experience adjudicating and resolving rejected pharmacy claims for bridge drug programs in a high-volume, daily workflow.
Experience interpreting common pharmacy claim rejection codes and identifying root-cause issues to drive first-pass resolution.
Experience verifying eligibility requirements and applying program rules to ensure compliant claim processing.
Experience applying basic pharmacy claims adjudication processes to convert rejected live claims into paid claims.
Experience supporting timely patient access to medications by prioritizing urgent claims and minimizing delays in therapy start.

Responsibilities

Ensures timely, compliant, and accurate completion of program deliverables.
Prepares and maintains reports for review by departmental management related to assigned program activities.
Collaborates with departments and completes day-to-day activities related to program assignment, including data entry and correction of errors.
Completes the coordination, authorization, fulfillment, monitoring, and tracking of health care services.
Partners with functional area experts and/or program managers to develop concise, complete, accurate, and clear specifications of program deliverables.