Revenue Cycle Support Specialist

PharMerica•Vancouver, WA

1d•Remote

About The Position

The Revenue Cycle Support Specialist (aka Prior Authorization Coordinator) is responsible for striving to complete either approval for pharmacy claims requiring prior authorization or by coordinating with prescribers and or facility contact to have therapy changed to a preferred alternative due to insurance not covering the treatment in question. PharMerica is a closed-door pharmacy where you can focus on fulfilling the pharmaceutical needs of our long-term care and senior living clients. We offer a non-retail pharmacy environment. Our organization is in high growth mode, which means advancement opportunities for individuals who are looking for career progression! Our Pharmacy group focuses on providing exceptional customer service and meeting the pharmacy needs for hospitals, rehabilitation hospitals, long-term acute care hospitals, and other specialized care centers nationwide. If your passion is service excellence and top-quality care come join our team and apply today!

Requirements

High School Diploma/General Education Diploma required
Excellent customer service and communication skills, both written and verbal
Ability to prioritize and meet pre-determined deadlines
Must be able to effectively multi-task, be proficient at typing, and have advanced technical skills
Experience in healthcare billing environment (pharmacy preferred)
Familiarization with on-line claims processing and Medicaid and Medicare billing practices
Proficient with Microsoft Word & Excel required
Must be able to effectively work during Pacific Time Zone hours

Nice To Haves

Pharmacy Technician preferred
Kentucky Pharmacy Technician License preferred

Responsibilities

Ensure accurate and timely completion of client prior authorization and/or change of therapy paperwork by collaborating with prescribers and facility contacts
Follows up on all claims requiring prior authorization within four to five business days
Tracks and reviews all claims in QuickBase and sends excel tracking spreadsheet to Director of Pharmacy on weekly basis
Compares system report of unbilled claims requiring prior approval to QuickBase tracking system to ensure any claim requiring prior authorization is being followed up on
Assists Billing Department with resolving unbilled claims at each month end close
Advocates for clients as needed
Support for Pharmacy Operations
Adjudicates and resolution of claim rejections as needed
Utilizes Frameworks, QuickBase, Docutrack, and CoverMyMeds in order to complete workflow on daily basis
Other responsibilities as assigned