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Eligibility Specialist

Key Facts

Remote From: 
Full time
Junior (1-2 years)
English

Other Skills

  • β€’
    Technical Acumen
  • β€’
    Adaptability
  • β€’
    Teamwork
  • β€’
    Personal Integrity
  • β€’
    Detail Oriented
  • β€’
    Reliability
  • β€’
    Social Skills
  • β€’
    Self-Motivation

Roles & Responsibilities

  • Strong computer skills and the ability to quickly learn to navigate Electronic Medical Records (EMR) and Pharmacy Dispensing Systems (PDS).
  • Highly organized, self-motivated with attention to detail, excellent interpersonal skills, high integrity, and dependability; ability to handle confidential information.
  • Energetic and motivated team player with willingness to do whatever is necessary for the betterment of the company; discretion and confidentiality essential.
  • Licensure/Education: State license required; PTCB certification strongly preferred but not required; willingness to obtain licensure within a mutually agreed timeframe; 0-1 years of experience as a Pharmacy Technician; high school diploma or GED.

Requirements:

  • Perform benefits investigations and utilize approved tools to identify insurance coverage; document outcomes clearly in the documentation tool.
  • Research patients' medical records for current medication regimens and complete benefits investigations using approved Pharmacy Dispensing Systems.
  • Collaborate with team members to provide an integrated approach to quality patient care; apply observations to operational issues, productivity, quality, and customer-service improvements; participate in process improvement initiatives.
  • Act as a value-added business partner to stakeholders throughout the organization and maintain confidentiality; update job knowledge through education opportunities and professional development; perform other duties as assigned.

Job description

Job Purpose:

  • Proactively grow the specialty pharmacy patient population by identifying patients that are eligible to fill with a Shields Partner Pharmacy.
  • Complete patient benefits investigations.
  • Protect Shields values by keeping information confidential.

Job Duties:

  • Perform benefits investigation.
  • Utilize multiple approved tools to identify insurance coverage.
  • Research within patients' medical records for current medication regimen.
  • Complete benefits investigation with approved Pharmacy Dispensing Systems.
  • Document clearly and concisely all outcomes of benefits investigation in documentation tool.
  • Collaborate with team members to provide an integrated approach of quality patient care.
  • Apply observations and recommendations to operational issues, increased productivity, quality, and customer-service standards.
  • Identify trends, resolve problems; recommend improvements; implement change.
  • Actively participate in process improvement initiatives.
  • Act as a value-added business partner to stakeholders throughout the organization.
  • Protect organization's values by keeping information confidential.
  • Update job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.
  • Other duties as assigned.

Skills:

  • We are looking for someone with strong computer skills and the ability to quickly learn to navigate Electronic Medical Records (EMR) and Pharmacy Dispensing Systems (PDS).
  • The applicant should be very organized self-motivated with attention to detail and have great interpersonal skills, high integrity and be dependable.
  • The ideal candidate will be an energetic and highly motivated, team player with a willingness to do whatever is necessary for the betterment of the company. Discretion and confidentiality are essential as position deals with highly sensitive and private data.

Experience/ Education:

Required Licensure/Certification:  We are seeking experienced pharmacy technicians. Nationally certified from PTCB or equivalent is strongly preferred but not required. State license is required. Dependent on hospital placement you may be required to become state certified. Should licensure need to be obtained, the applicant will commit to obtaining the required licensure within a mutually agreed upon timeframe. Continued employment is contingent upon meeting these requirements.

Years of Experience: 0-1 years' experience as a Pharmacy Technician.

Required Education: High school diploma or GED.

 

This information is being provided to promote pay transparency and equal employment opportunities at Shields Health Solutions. The current salary range for this position is $18.00 per hour to $20.00 per hour. The actual hourly salary within this range that you will be offered will depend on a variety of factors including geography, skills and abilities, education, experience, and other relevant factors. 

California residents employed by or applying for work at Shields have certain privacy rights. Please review our: California Workforce Privacy Notice and Privacy Policy.  

By providing your mobile number, you agree to receive text messages from Shields Health Solutions related to job opportunities, interview scheduling, and recruiting updates. Message and data rates may apply. You may opt out at any time by replying 'STOP.' Consent is not a condition of employment.

Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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