Pharmacy Reimbursement Specialist
On-siteBeaufort, South Carolina, United States
Job Summary
Manage drug and agent ordering, insurance verification, pre-authorization, and claim reconciliation to ensure Beaufort Memorial Hospital obtains appropriate and highest reimbursement for outpatient infusion center claims. Follow up on claim adjudication to address rejects, underpayments, and appropriate reimbursement with payer contacts while assisting with co-pay and drug reimbursement cards to minimize patient out-of-pocket costs. Collaborate closely with prescribing physicians, nurse practitioners, pharmacy, finance, pre-authorization, infusion, and oncology staff in a highly matrixed environment. Requires SC State Pharmacy Technician registration and proficiency in Microsoft Office applications.
Required Qualifications
- SC State Pharmacy Technician registration required
- Willingness to work a variety of schedules to include long hours, evenings, holidays and weekends
Desired Qualifications
- High School graduate preferred
- some college preferred
- Minimum 1 year of Clinical experience in Pharmacy technology, Infusion Therapy, or some related field preferred
- Experience with medical insurance claims reconciliation preferred
- Service excellence, patient, and family centered care by showing respect, honesty, fairness and a positive attitude toward all patients
- Superior written and verbal communication skills that can be applied for interviewing patients, family, care providers, and interacting with interdisciplinary staff, and external resources
- Ability to assess work activities and allocate resources appropriately; ability to work independently, prioritize tasks efficiently to meet expected periods, and handle stress appropriately
- Basic understanding of cultural diversity
- Proficient computer skills and Microsoft Office applications
- SC State Certified Pharmacy Technician license preferred
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