Financial Coordinator - Pharmacy

Lehigh Valley Health Network•Allentown, PA

2d•Onsite

About The Position

Monitors and obtains financial information and authorizations to ensure appropriate coverage for patients related to Home Infusion Pharmacy, Nursing and Specialties. Communicates medical conditions and treatment plans to carriers and suppliers to determine coverage. Obtains authorizations for services if needed. Provides counseling to patients and their families regarding covered services and financial responsibility. Monitors, applies payments and adjustments on Accounts Receivable. Works closely with Pharmacy to coordinate outpatient infusion services. Knowledge of pharmacy operations is required.

Requirements

High School Diploma/GED
3 years Insurance verification or medical billing.
3 years in a Pharmacy related field
Knowledge of medical terminology and all aspects of coding including ICD-10, CPT, and HCPCS.
Computer proficiency.
Knowledge of insurance carriers, Medicare, Medicaid, and managed care regulations.
Knowledge of third-party insurance medical benefits and billing requirements.
Knowledge of pharmacy operations including order preparation, patient monitoring and home delivery.

Nice To Haves

Bachelor’s Degree
CPhT - Certified Pharmacy Technician - State of Pennsylvania Upon Hire

Responsibilities

Acts as the financial representative to all potential pharmacy patients.
Maintains a perpetual knowledge of pharmacy Payer standards and requirements for pharmacy patient billing.
Educates patients on coverage, prescription coverage, and any assistance programs that they may be eligible.
Obtains pre-certification and/or prior authorization if required by insurance companies and ensures that they are always up-to-date and active.
Verifies accuracy of billing and payment information received and assists in obtaining more information.
Verifies patient insurance coverage including prescription coverage.
Maintains up-to-date documentation regarding insurance information and coverage.
Serves as a billing and insurance resource for colleagues, physicians, and patients.