HUB Patient Services Coordinator - Remote

Description

POSITION SUMMARY
This position will be key to communication with prescriber offices and an education subject matter expert for all benefits investigation, benefits verification, and claims processing support for a manufacturer’s drug product regardless of the distribution channel. This includes an understanding of patients’ benefits plan design and the knowledge to provide educational assistance to health care providers with claims support. This individual will understand all aspects of processing referrals through all steps of the process from enrollment through approval of the patient’s insurance and or to a final outcome of the benefits investigation. This position will be a single point of contact with health care providers and others involved in the patients process to receive drug product. The individual will work closely with other members of the patient support services team including the program manager, program liaison, and other involved in the process.  The position will document all benefits and authorizations and or troubleshoot any rejections. The position will also reverify benefits and reverify authorizations as needed on any recurring patients.

REQUIRED KNOWLEDGE, SKILLS & TRAINING

• 3+ years of experience working within a prescriber office handling buy/bill insurance claims as well as understanding of Major Medical Insurance and Pharmacy Drug Benefits
• Knowledge of medical and insurance terminology
• Knowledge of HCPCs codes and office administered claims processing
• Able to multitask and work in a fast-paced environment
• Able to work well with other teams within the organization
• Able to meet basic performance metrics and goals of the department
• Able to provide good customer service communication and use good phone skills
• Experienced using spreadsheets, the internet, insurance websites, and phone system to work effectively
• Able to communicate with insurance plans and document benefits into the system

ESSENTIAL JOB DUTIES

• Perform benefit investigation/verifications through the medical and pharmacy benefits
• Submit and obtain prior authorizations with insurance companies
• Troubleshoot pharmacy claims rejection, medical claim denials, and prior authorization/appeal requirements
• Perform Monthly Re-verifications and Re-authorizations
• Provide accurate, professional summary of benefits as needed
• Educate customers for successful patient support needs
• Utilize a sense of urgency and accountability to prioritize urgent issues
• Attentive to accurate detail and documentation requirements
• Other related duties as assigned

EMPLOYEE BENEFITS

• BCBSL Medical
• Delta Dental
• EyeMed Vision
• 401k
• Accident & Critical Illness
• Life Insurance
• PTO, Holiday Pay, and Floating Holidays
• Tuition Reimbursement