Pharmacy Benefits Specialist

CAROLINA ASTHMA AND ALLERGY CENTER MASTER•Shelby, NC

2d•Onsite

About The Position

A nonexempt position responsible to coordinate the activity of pharmaceuticals, such as Xolair, for the practice. These responsibilities will include: Appointment scheduling; Obtaining prior authorizations; Ordering; Inventory tracking & reconciliation; Collecting patient-due amounts; and other needed tasks.

Requirements

At least 1 year of insurance verification, and charge auditing

Nice To Haves

Ability to multi-task
Attention to detail
Ability to read accounts and understand medical terms
Excellent customer service and communication skills
Exhibit high level of professional behavior
Ability to learn quickly and work well under pressure
Ability to work independently and as a team

Responsibilities

Determine if the pharmaceutical should be handled as Buy & Bill or Specialty Pharmacy
Obtain pre-authorization for drug purchase
Order pharmaceutical from the drug company
Assist patient with copay assistance
Provide estimates to patients on their financial responsibility
Checks and balances to verify that we are ordering and billing correctly
At the end of each day run scheduling and charge reports to ensure that Buy & Bill and Specialty Pharmacy injections have been billed appropriately
Collect patient-due amounts
Accounts Receivables - follow up, denials monitoring and appeals
Monitor and track drug inventory per location
Other tasks as requested by supervisor