Pre-Cert Coordinator Infusion

Edmond, OK 73013

Employment Type: Perm Job Category: Administrative Job Number: 25049

Job Description

Pre-Cert Coordinator
Location: Edmond, OK (onsite) 

Job Summary:

Working as a part of the Patient Benefits Coordination team for our client, 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:
  • Verifying benefits and eligibility for both new and existing patients to process patient benefits in a timely manner; including necessary prior authorizations
  • Calculates patient due portions based on insurance and pharmacy verification
  • Communicates with patient on their payment expectations
  • Understanding insurance carriers and concepts including drug cards, major medical and pharmacy benefits, and knowledge of government and patient assistance programs
  • Validating patient copay assistance programs
  • Processing all outside infusion referrals
  • Reviewing payment records for patients and third parties, ensuring fees are collected properly
  • Answering phone calls and returning voicemails in a timely manner
  • Checking and resolving assigned tasks in Electronic Health Records
  • Set the standard for the team with excellent patient care
  • Be available to team to offer assistance, information, and directions
  • Maintain open and positive lines of communication, and functionality
  • Understand and adhere to HIPAA laws and regulations in compliance and patient confidentiality
Performance Requirements:
 
Knowledge:
  • Pharmacy, PBM, or Specialty pharmacy experience a plus
  • Knowledge of government and patient assistance programs
  • Excellent customer service skills
  • Attention to detail
  • Analytical and problem solving skills
  • Knowledge of Medicare, Medicaid, and third party vendors
  • Proficient in Microsoft-Able to type 50 words per minute
  • EHR system experience
  • Office (Outlook, Word, Excel, PowerPoint)
Qualifications for the Role:
  • 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:
  • Ability to work effectively in a fast-paced environment.
  • Physical ability to sit, perform data entry and view computer screen for long periods at a time.
  • Occasional exposure to communicable diseases and biohazards.
  • Daily standing, walking, bending, and maneuvering.
  • May require lifting up to 50 pounds or more to transfer and/or turn patient with and without assistive devices.
 

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About Edmond, OK

Discover your next career opportunity in the vibrant city of Edmond, Oklahoma! Nestled just north of Oklahoma City, Edmond offers a unique blend of small-town charm and big-city amenities. From the bustling downtown area with its quaint cafes and local boutiques to the thriving arts scene showcased at the Edmond Fine Arts Institute and Armstrong Auditorium, there's something for everyone here. With easy access to Lake Arcadia for outdoor enthusiasts and the University of Central Oklahoma for lifelong learners, the possibilities for growth and fulfillment are endless. Join us in exploring job listings in this dynamic region and unlock your potential in the heart of Oklahoma!