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Insurance Verification & Medical Dispensary Coordinator

Company: e+CancerCare
Location: Casper
Posted on: August 8, 2019

Job Description:

Job Purpose: The Authorization Specialist is responsible for verifying patient's eligibility, coordinating medical benefits, gaining approval for planned procedures and services. The In-Office Dispenser under the supervision of a physician supports pharmacy services assisting with oversight, monitoring, preparation, dispensing and proper documentation of patient medication therapy. Essential Functions: -- Verify private, government and third party insurance information. -- Verify any secondary and tertiary medical insurance benefits. -- Obtain, review and input insurance authorization and referrals prior to patient services and throughout treatment to maintain continuance of authorizations. -- Advocate for the patient utilizing knowledge of coverage based guidelines and treatments. -- Monitor and track patient authorizations and communicate changes to the appropriate team members. -- Identifies and provides accurate CPT/ICD codes where needed for reimbursement. -- Maintains and submits appropriate logs and reports to professional, state and federal entities as required including, but not limited to; Medicaid and Medicare. -- Obtains, interprets and submits clinical documentation pertinent to the specific services requiring prior authorization to support medical necessity review by the payer. -- Follows up on denied authorizations requests and relays the necessary denial detail to the provider to facilitate the appeal and/or peer to peer review . -- Works closely with Sr. Authorization Specialist. -- Works closely with the Financial Counselor, Patient Navigator, Nursing and front office staff. -- Maintains appropriate documentation in the registration and electronic medical record systems. -- Regular attendance and punctuality. -- Ensures that all processing and reporting deadlines are consistently achieved. -- Performs other functions as required by management. -- Knowledge of medications and their indication, contraindications, dosing, side effects and proper administration and/or ability to learn. -- Knowledge of accepted medication resources and information databases and/or ability to learn. -- Reviews medication orders and contacts prescriber for clarification. -- Preparation, labeling and dispensing of oral medications. -- Provides drug information as appropriate to patients. -- Disbursement of prescriptions to non-local patients as needed. -- Maintains methods and manner of storage and record keeping systems to provide for safekeeping of pharmaceuticals. -- Inventory control of dispensary medications and supplies. -- Follows departmental policies, procedures and objectives, continuous quality improvement objectives and safety, environmental and/or infection control standards and patient confidentiality. Qualifications and Education Requirements -- Medical Assistant, LPN or Pharmacy Technician highly preferred -- Basic PC skills Preferred Skills -- Oncology background -- Knowledge of ICD9/10 diagnosis codes, CPT codes -- Basic knowledge of medical/pharmacy terminology Required Competencies Strong business and organizational competence, exceptional customer service skills ,interpersonal skill competency, adaptability, accountability, integrity, time management skills with an emphasis on multi-taskingThe Tennessean. Category: , Keywords: Medical Authorization Specialist

Keywords: e+CancerCare, Casper , Insurance Verification & Medical Dispensary Coordinator, Healthcare , Casper, Wyoming

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