CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services.

Job Details:

Manage the daily functions of the Insurance Verification area including verification of insurance coverage, re-verifying coverage for existing patients, enter and update patient demographics into the computer system, and securing reimbursement related paperwork. Support the Supervisor of Insurance Verifications with case management, price quotes, price negotiation, unbilled, and spot deals.

Responsibilities

• Verifies patients’ insurance benefits accurately specific to the therapy provided.

• Run pharmacy benefit claim with accurate NDC as required

• Communicate to pharmacy appropriate NDC required if applicable

• Initiate authorization if required

• Obtain and process credit card if applicable

• Coordinate completion of Financial Assistance forms, payment agreements and waivers.

• Research and assists patients with copay assistance programs and/or through foundations and/or manufacturers if applicable.

• Enter and update patient demographics into the computer system.

• Generate financial responsibility letter.

• Review benefits and financial responsibility with patient or family member.

• Demonstrates reliability and follow-through on all assigned tasks.

• Support lead responsibilities as needed.

• Ability to work commercial, self-pay, pharmacy claims, and/or specialty.

• Assist in training of new employees.

• Create new hospital and physician codes as needed.

• Give high priority to client satisfaction and customer needs.

• Cooperate with other staff members when planning and organizing reimbursement activities.

• Prioritize activities needed to be done.

• Assist in generating price quotes.

• Assist in price negotiation with case managers.

• Assist in researching reimbursement issues.

• Performs in accordance with system-wide competencies/behaviors.

• Performs other duties as assigned.

Skills & Abilities

• Excellent written and verbal communication

• Organization

• Time Management

• Professional

Requirements

• Associates degree OR equivalent combination of education and experience.

• 2+ years of experience in home IV therapy and/or insurance verifications.

• Knowledge of medical terminology preferred

• Capable of managing multiple priorities.

• Excellent math skills

CarepathRx offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire .

CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.