Pre-Cert Coordinator - Infusion

Oklahoma Arthritis Center (OAC) is an Equal Employment Opportunity employer and considers all applicants without regard to race, religion, color, sex, national origin, age, disability, veteran status, or any other legally protected status.

Job Summary:

Working as a part of the Patient Benefits Coordination team, this employee will be responsible for daily financial coordination functions, patient relations, compliance, learning and development, and process development and significant contribution to the team.

Essential Functions:

Verifying benefits and eligibility for both new and existing patients to process patient benefits in a timely manner; including necessary prior authorizations

Calculates patient due portions based on insurance and pharmacy verification

Communicates with patient on their payment expectations

Understanding insurance carriers and concepts including drug cards, major medical and pharmacy benefits, and knowledge of government and patient assistance programs

Validating patient copay assistance programs

Processing all outside infusion referrals

Reviewing payment records for patients and third parties, ensuring fees are collected properly

Answering phone calls and returning voicemails in a timely manner

Checking and resolving assigned tasks in Electronic Health Record

Adhere to compliance of OAC policies and standard operating procedures

Set the standard for the team with excellent patient care

Be available to team to offer assistance, information, and directions

Maintain open and positive lines of communication, and functionality

Understand and adhere to HIPAA laws and regulations in compliance and patient confidentiality

Performance Requirements:

Knowledge:

Pharmacy, PBM, or Specialty pharmacy experience a plus

Knowledge of government and patient assistance programs

Excellent customer service skills

Attention to detail

Analytical and problem solving skills

Knowledge of Medicare, Medicaid, and third party vendors

Proficient in Microsoft-Able to type 50 words per minute

EHR system experience

Office (Outlook, Word, Excel, PowerPoint)

Qualifications:

Associate’s or Bachelor’s degree in healthcare, business, finance, other related field, or equivalent experience, a plus

2-3 years of experience with medical insurance, benefits verification, prior authorizations, medical billing, or a related field 

Physical Requirements:

Ability to work effectively in a fast-paced environment.

Physical ability to sit, perform data entry and view computer screen for long periods at a time.

Occasional exposure to communicable diseases and biohazards.

Daily standing, walking, bending, and maneuvering.

May require lifting up to 50 pounds or more to transfer and/or turn patient with and without assistive devices.

Travel Requirements: 

Travel may be required.

Scheduled Working Hours:

Normal work hours are 8:00 a.m. to 5:00 p.m., Monday through Thursday and 8:00 a.m. to 1:00 p.m. on Fridays. Hours may vary depending upon the needs of the position, department, and clinic.

Other Duties:

Please note this job description is not designed to cover or to contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change from time to time, with or without notice.

Equipment Operated:

Standard office equipment including: computers, printers, faxes, copiers, postage machine, etc.