Pharmacy Patient Insurance Coordinator

Title: Pharmacy Patient Insurance Coordinator

Location: Long Beach

Department: Ambulatory Pharmacy Revenue Cycle

Status: Full Time

Shift: Day

Pay Range*: $22.22/hr-$32.21/hr

At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in Healthcare.Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability.Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork.

Position Summary

The Coordinator for the Respiratory Syncytial Virus (RSV) Clinic is responsible for scheduling patients for the RSV clinic, obtaining insurance authorization for service, verifying patient eligibility, billing for services and insuring the maximum allowable payment for the services rendered. The Coordinator is also responsible for working with the clinical staff in contract negotiations with insurance companies and medical groups. The Coordinator also collects data and reports on the financial viability of the RSV clinic.

Essential Functions and Responsibilities of the Job

1. Contacts patients' representatives, and effectively schedules patients and coordinates their insurance coverage. The Coordinator informs patients' representatives of their financial responsibility. The Coordinator refers clinical questions to the appropriate clinical resources.

2. Obtains initial insurance company authorization for service for each patient, and when necessary obtains follow-up authorization.

3. Processes insurance claims completely, meeting all contractual requirements for timeliness.

4. Collects data and generates reports that allow contracting personnel to effectively negotiate with payors.

5. Regularly educates RSV clinic staff and billing and collections staff on changes in insurance plans, contracts, insurance company billing policies and other procedures related to the RSV clinic to insure the optimum financial performance of the clinic.

6. Performs other duties as assigned.

*Placement in the pay range is based on multiple factors including, but not limited to, relevant years of experience and qualifications. In addition to base pay, there may be additional compensation available for this role, including but not limited to, shift differentials, extra shift incentives, and bonus opportunities. Health and wellness is our passion at MemorialCare-that includes taking good care of employees and their dependents. We offer high quality health insurance plan options, so you can select the best choice for your family. And there's more...Check out ourMemorialCare Benefitsfor more information about our Benefits and Rewards.

Qualifications - External

Experience

* 2 + years infusion insurance billing experience, familiarity with insurance billings and collections processes

* Knowledge of basic bookkeeping practices

* Filing experience

* PC proficiency (Excel, Word, MS Office)

* Knowledge of generally accepted accounting practices and principles.

Education

* AAIBA Business degree or equivalent work Experience