Pre-Cert Coordinator - Infusion

Oklahoma Arthritis Center (OAC) is an Equal Employment Opportunity employer and considers all applicants without regard to race, religion, color, sex, national origin, age, disability, veteran status, or any other legally protected status.

Job Summary:

Working as a part of the Patient Benefits Coordination team, this employee will be responsible for daily financial coordination functions, patient relations, compliance, learning and development, and process development and significant contribution to the team.

Essential Functions:

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  Verifying benefits and eligibility for both new and existing patients to process patient benefits in a timely manner; including necessary prior authorizations
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  Calculates patient due portions based on insurance and pharmacy verification
• Communicates with patient on their payment expectations
  
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  Understanding insurance carriers and concepts including drug cards, major medical and pharmacy benefits, and knowledge of government and patient assistance programs
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  Validating patient copay assistance programs
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  Processing all outside infusion referrals
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  Reviewing payment records for patients and third parties, ensuring fees are collected properly
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  Answering phone calls and returning voicemails in a timely manner
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  Checking and resolving assigned tasks in Electronic Health Record
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  Adhere to compliance of OAC policies and standard operating procedures
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  Set the standard for the team with excellent patient care
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  Be available to team to offer assistance, information, and directions
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  Maintain open and positive lines of communication, and functionality
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  Understand and adhere to HIPAA laws and regulations in compliance and patient confidentiality

Performance Requirements:

Knowledge:

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  Pharmacy, PBM, or Specialty pharmacy experience a plus
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  Knowledge of government and patient assistance programs
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  Excellent customer service skills
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  Attention to detail
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  Analytical and problem solving skills
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  Knowledge of Medicare, Medicaid, and third party vendors
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  Proficient in Microsoft-Able to type 50 words per minute
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  EHR system experience
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  Office (Outlook, Word, Excel, PowerPoint)

Qualifications:

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  Associate’s or Bachelor’s degree in healthcare, business, finance, other related field, or equivalent experience, a plus
• 2-3 years of experience with medical insurance, benefits verification, prior authorizations, medical billing, or a related field 

Physical Requirements:

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  Ability to work effectively in a fast-paced environment.
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  Physical ability to sit, perform data entry and view computer screen for long periods at a time.
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  Occasional exposure to communicable diseases and biohazards.
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  Daily standing, walking, bending, and maneuvering.
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  May require lifting up to 50 pounds or more to transfer and/or turn patient with and without assistive devices.
  

Travel Requirements: 

Travel may be required.

Scheduled Working Hours:

Normal work hours are 8:00 a.m. to 5:00 p.m., Monday through Thursday and 8:00 a.m. to 1:00 p.m. on Fridays. Hours may vary depending upon the needs of the position, department, and clinic.

Other Duties:

Please note this job description is not designed to cover or to contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change from time to time, with or without notice.

Equipment Operated:

Standard office equipment including: computers, printers, faxes, copiers, postage machine, etc.