The Pharmacy Benefit Coordinator (PBC) is a data entry/customer service role to provide quality customer service to our partners across the United States. Primary functions include facilitating the proper adjudication of medications for hospice patients, process admission and discharges from the computer system, formulary management for facilitation of payment, and troubleshooting issues reported by hospice partners, pharmacists, and community pharmacies. PBC’s are dedicated to ensuring the hospice benefit is properly utilized and patient needs are being met.

Position can go remote/hybrid for 3-4 days of the week after 9 monhts of employment.

1. Processes consults via information provided and accurately completing the data entry in the billing proprietary software.
2. Navigates between various software systems for communication and completion of assignments.
3. Communicates both directly and indirectly within the organization and with hospice partners via chat, email, phone calls, and patient profile documentation.
4. Assists with verification that pharmacy claims for appropriate processing. Provides appropriate and accurate information to local pharmacies in accordance with approved insurance information as determined by Delta Care and hospice partner (i.e., Name, DOB, ID, BIN, Group, medication benefits, etc.).
5. Answers the phone, responds to routine questions and outreaches to a pharmacist as needed.
6. Accurately includes necessary information when assisting clinicians for the procurement of hospice patient medication requirements.
7. Assists with acquiring and completing the Prior Authorization process with hospice partners to provide adequate insurance coverage at local pharmacies.
8. Completes non-queue work related tasks such as hospice census, preparation of go live information, processing spreadsheets, retroactive adjudication, and FedEx delivery.
9. Outreaches to pharmacy partners to complete stock checks and/or medication procurement, to ensure medications are available for patient care. Assists with dispatching medications for hospice partners.
10. Completes assigned responsibilities with a high level of efficiency and accuracy. Works cooperatively with fellow Pharmacy Benefit Coordinator (PBC) team members and others on various teams throughout the organization. Maintains a high level of productivity while balancing quality of care.
11. Assists in training new team members as assigned.

We are an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.

Job Type: Full-time

Pay: $16.00 - $19.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Referral program
• Vision insurance

Experience level:

• 1 year

Shift:

• Morning shift
• Rotating shift

Weekly day range:

• Monday to Friday
• Rotating weekends
• Weekends as needed

Work setting:

• Hybrid work
• Office

Application Question(s):

• This position requires a high level of multitasking. Does that work for you?
• This positions will be in office at first and can go remote after 9 months of employment. We have 2 offices we operate out of and they are in Zip Code 15021 and 15205

Would that work for you?

Experience:

• Customer Service - Over the Phone: 1 year (Preferred)

Work Location: Hybrid remote in Burgettstown, PA 15021