Clinical Support Coordinator - BioPlus Specialty Pharmacy
HybridLake Mary, Florida, United States or Harvey, Louisiana, United States
EXPIREDLake Mary, Florida, United States or Harvey, Louisiana, United StatesHybridFull TimeHigh School Or EquivalentEnterprise
Full TimeHigh School Or EquivalentEnterprise
Job Summary
Ensure timely, compliant, and accurate completion of program deliverables by preparing reports for management review and collaborating on process improvement initiatives. Coordinate, authorize, fulfill, and track health care services while partnering with experts to define precise program specifications. Execute day-to-day program assignment activities including data entry, error correction, and adjudicating rejected pharmacy claims to drive first-pass resolution. Prioritize urgent claims to minimize therapy delays and verify eligibility requirements for compliant processing.
Required Qualifications
- HS diploma or equivalent
- Minimum of 3 years experience in a general office/administrative environment
- Any combination of education and experience, which would provide an equivalent background
- Hybrid work arrangement (in-office 1-2 days per week)
- Location within reasonable commuting distance of LA-HARVEY or FL-LAKE MARY
- Monday-Friday, 8:30am-5:00pm schedule
- COVID-19 vaccination
- Influenza vaccination
Desired Qualifications
- Managed healthcare experience
- Experience working in a high call volume environment
- Experience adjudicating and resolving rejected pharmacy claims for bridge drug programs in a high-volume, daily workflow
- Experience interpreting common pharmacy claim rejection codes and identifying root-cause issues to drive first-pass resolution
- Experience verifying eligibility requirements and applying program rules to ensure compliant claim processing
- Experience applying basic pharmacy claims adjudication processes to convert rejected live claims into paid claims
- Experience supporting timely patient access to medications by prioritizing urgent claims and minimizing delays in therapy start
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