Medication Access Coordinator - Medical Billing

Nebraska Medicine•Omaha, NE

14d•Hybrid

About The Position

Serious Medicine is what we do. Being extraordinary is who we are. Every colleague plays a key role in upholding this promise to our patients and their families. Shift: First Shift (United States of America) Medication Access Coordinator – Medical Billing $1,000 Sign-On Bonus! Role Highlights Nebraska Medicine is now accepting applications for an experienced Medication Access Coordinator to join our Retail/Specialty Pharmacy team, focusing on home infusion medical billing. This position is based at our Central Fill location (approx. 114th and Dodge in Omaha, NE) with the option to work remotely. Candidates must reside in Nebraska or Iowa. Also known as: Medical Billing, Reimbursement Specialist, Pharmacy Advocate, Pharmacy Insurance Tech, Pharmacy Technician, Pharmacy Financial Counselor Medication Access Coordinator - Medical Billing: Determine, support, and assist patients, provider teams, and the pharmacy department to overcome barriers to medication access, with focused expertise in third party prior authorization and billing processes for pharmacy benefits. Assist patients within enrollment into grants, assistance programs, and communicate any financial responsibilities. Provide a Face-to Face/virtual beside oriented service that delivers comprehensive fiscal options to patients. Gather and effectively communicate medical and medication histories including diagnosis, test results, lab values, and previous medications to third party. Verify eligibility, pharmacy benefit provisions and support the appeals process. Nebraska Medicine includes two hospitals, the state's largest and highest rated Nebraska Medical Center and Bellevue Medical Center, along with more than 70 primary care and specialty clinics. Nebraska Medicine and our research and education partner, the University of Nebraska Medical Center (UNMC), share the same mission: to lead the world in transforming lives to create a healthy future for all individuals and communities through premier educational programs, innovative research and extraordinary patient care. Every colleague plays a key role in upholding our promise of “Serious Medicine, Extraordinary Care” to our patients and their families. Working with Nebraska Medicine means committing to meaningful, impactful work that will elevate the success of your fellow colleagues and will help our patients and their families feel comfortable, confident and cared for. Use this tool to search for jobs with Nebraska Medicine. Opportunities include full-time, part-time and casual positions in patient care, nursing, nursing support, allied health, diagnostics, administration, customer service, facilities, IT and more. If you are seeking Physician Opportunities, please visit NebraskaMed.com/Careers/Physician-opportunities For opportunities in Food and Environmental Services, please visit NebraskaMed.com/Careers/Food-environmental-services The option to create an automated alert of new job postings is available to candidates. You must create/sign in to our external career site by clicking “Sign In” in the top right corner of the page. If you have not created a sign in yet, please follow the directions on the page. A confirmation email will be sent that you must confirm before any job alerts will be sent. Job alerts are sent daily when a new job requisition is posted that meets your job alert criteria.

Requirements

Minimum of 3 years’ experience in retail/specialty pharmacy insurance or payer systems (Medicaid, Medicare, or private insurance)
Familiarity with CPR+ or CareTend software
Strong problem-solving and patient advocacy skills
Detail orientation with excellent documentation and follow-up
Minimum of three years healthcare and/or insurance/third party reimbursement experience.
High school education or equivalent required.
Excellent interpersonal skills and the ability to successfully interact with a variety of internal and external customers at all levels required.
Ability to solve problems independently and must be strongly vested in team management required.
Ability to multi-task and excel in a dynamic environment required.
Experience with various computer mainframe, network, web based and payer applications required.
Must register with the State of NE as a pharmacy technician required.
Must complete Pharmacy Technician Certification within one year required.

Nice To Haves

Knowledge of commercial, Medicare B, Medicare D, and Medicaid pharmacy rules and regulations preferred.
Associate's degree in business, healthcare or related field preferred.
Bi-lingual preferred.
Prior Authorization experience in specialty or retail pharmacy preferred.
340B knowledge and experience preferred.
Apexus 340B OnDemand Certificate preferred.
One year of pharmacy technician experience preferred.

Responsibilities

Conduct medical billing benefit investigations
Complete prior authorizations and insurance appeals
Remove medication access barriers and support patients with coverage needs
Apply expertise in DME billing, payer-specific infusion coverage guidelines, and home infusion services
Document and follow up in a fast-paced, desk-based environment
Determine, support, and assist patients, provider teams, and the pharmacy department to overcome barriers to medication access, with focused expertise in third party prior authorization and billing processes for pharmacy benefits.
Assist patients within enrollment into grants, assistance programs, and communicate any financial responsibilities.
Provide a Face-to Face/virtual beside oriented service that delivers comprehensive fiscal options to patients.
Gather and effectively communicate medical and medication histories including diagnosis, test results, lab values, and previous medications to third party.
Verify eligibility, pharmacy benefit provisions and support the appeals process.