Memorial Healthcare System
Infusion Pharmacy Intake Coordinator - FT - Days - Memorial Specialty Pharmacy
Memorial Healthcare System, Miramar, Florida, United States
Infusion Pharmacy Intake Coordinator - FT - Days - Memorial Specialty Pharmacy
Location: Miramar, Florida At Memorial Healthcare System (MHS), our ever-growing pharmacy career options present unlimited opportunities to individuals passionate about advancing pharmacy practice. As a nationally recognized and respected leader for providing “A-rated” patient care and safety, MHS prides itself on being able to grow and adapt to the rapidly evolving needs of our community and healthcare industry. Summary
The Pharmacy Intake Coordinator plays a critical and complex role at the intersection of clinical pharmacy operations and health benefit coordination. This position is responsible for managing the intake process for specialty and traditional parenteral therapies, ensuring the timely collection and validation of clinical information, patient eligibility, benefit verification, and prior authorization requirements. It involves a strong understanding of benefit design, including formulary status, plan coverage, copay assistance programs, and 340B program eligibility. The role serves as a liaison between providers, patients, pharmacy staff, and payers, navigating a dynamic environment that requires attention to detail, medical knowledge, and strong communication skills. Responsibilities
Notifies patients/families regarding insurance coverage and payment responsibilities. Ensures referral process is completed prior to submitting referral to pharmacy for medication dispense and delivery. Communicates and coordinates with home health agencies for patient acceptance, including submission of service orders and other pertinent information required by home health. Collects and inputs medical information into EMR applications including diagnosis, medical history, medication history, allergies, etc. Assists with prior authorization process for pharmacy and medical claims. Performs test claim submissions for drug, supply items and DME. Reviews and evaluates new referral documents for appropriateness in the outpatient setting. Verifies prescriber licensure for referral and updates EMR for billing processing. Processes all required paperwork and documentation required for referral acceptance according to department policies. Competencies
ACCOUNTABILITY CLINICAL DOCUMENTATION REVIEW CUSTOMER SERVICE DOCUMENTATION EFFECTIVE COMMUNICATION MEDICAL TERMINOLOGY RESPONDING TO CHANGE STANDARDS OF BEHAVIOR VERIFYING INSURANCE Education And Certification Requirements
High School Diploma or Equivalent (Required). ARMA Certified Medical Assistant (ARMA), Certified Pharmacy Technician (CPHT) - Pharmacy Technician Certification Board (PTCB), Licensed Practical Nurse (LPN) - State of Florida (FL). Additional Job Information
Complexity of Work: The role requires the ability to multitask and manage time efficiently with minimum supervision. Strong communication, organizational, problem-solving, and interpersonal skills. In-depth understanding of third-party insurance billing practices, as well as federal and state regulations with regard to billing and reimbursement. Knowledge of medical terminology as it relates to infusion therapy and durable medical equipment is strongly recommended. Required Work Experience: Minimum of two (2) years of experience in a healthcare setting involving patient intake, insurance verification, or care coordination, preferably in home health, infusion services, specialty pharmacy or a similar field. Other Information: Must be a Certified Medical Assistant, LPN, or Certified Pharmacy Technician Working Conditions And Physical Requirements
Keyboard Entry = 80% Lifting or Carrying 0 - 25 lbs Non-Patient = 20% Lifting or Carrying 25 - 75 lbs Non-Patient = 20% Pushing or Pulling 0 - 25 lbs Non-Patient = 20% Reaching = 20% Sitting = 80% Computer Monitor = 80% Shift: Days Disclaimer: This job description is not exhaustive. Wages shown on independent job boards reflect market averages. Memorial Healthcare System is an equal opportunity employer.
#J-18808-Ljbffr
Location: Miramar, Florida At Memorial Healthcare System (MHS), our ever-growing pharmacy career options present unlimited opportunities to individuals passionate about advancing pharmacy practice. As a nationally recognized and respected leader for providing “A-rated” patient care and safety, MHS prides itself on being able to grow and adapt to the rapidly evolving needs of our community and healthcare industry. Summary
The Pharmacy Intake Coordinator plays a critical and complex role at the intersection of clinical pharmacy operations and health benefit coordination. This position is responsible for managing the intake process for specialty and traditional parenteral therapies, ensuring the timely collection and validation of clinical information, patient eligibility, benefit verification, and prior authorization requirements. It involves a strong understanding of benefit design, including formulary status, plan coverage, copay assistance programs, and 340B program eligibility. The role serves as a liaison between providers, patients, pharmacy staff, and payers, navigating a dynamic environment that requires attention to detail, medical knowledge, and strong communication skills. Responsibilities
Notifies patients/families regarding insurance coverage and payment responsibilities. Ensures referral process is completed prior to submitting referral to pharmacy for medication dispense and delivery. Communicates and coordinates with home health agencies for patient acceptance, including submission of service orders and other pertinent information required by home health. Collects and inputs medical information into EMR applications including diagnosis, medical history, medication history, allergies, etc. Assists with prior authorization process for pharmacy and medical claims. Performs test claim submissions for drug, supply items and DME. Reviews and evaluates new referral documents for appropriateness in the outpatient setting. Verifies prescriber licensure for referral and updates EMR for billing processing. Processes all required paperwork and documentation required for referral acceptance according to department policies. Competencies
ACCOUNTABILITY CLINICAL DOCUMENTATION REVIEW CUSTOMER SERVICE DOCUMENTATION EFFECTIVE COMMUNICATION MEDICAL TERMINOLOGY RESPONDING TO CHANGE STANDARDS OF BEHAVIOR VERIFYING INSURANCE Education And Certification Requirements
High School Diploma or Equivalent (Required). ARMA Certified Medical Assistant (ARMA), Certified Pharmacy Technician (CPHT) - Pharmacy Technician Certification Board (PTCB), Licensed Practical Nurse (LPN) - State of Florida (FL). Additional Job Information
Complexity of Work: The role requires the ability to multitask and manage time efficiently with minimum supervision. Strong communication, organizational, problem-solving, and interpersonal skills. In-depth understanding of third-party insurance billing practices, as well as federal and state regulations with regard to billing and reimbursement. Knowledge of medical terminology as it relates to infusion therapy and durable medical equipment is strongly recommended. Required Work Experience: Minimum of two (2) years of experience in a healthcare setting involving patient intake, insurance verification, or care coordination, preferably in home health, infusion services, specialty pharmacy or a similar field. Other Information: Must be a Certified Medical Assistant, LPN, or Certified Pharmacy Technician Working Conditions And Physical Requirements
Keyboard Entry = 80% Lifting or Carrying 0 - 25 lbs Non-Patient = 20% Lifting or Carrying 25 - 75 lbs Non-Patient = 20% Pushing or Pulling 0 - 25 lbs Non-Patient = 20% Reaching = 20% Sitting = 80% Computer Monitor = 80% Shift: Days Disclaimer: This job description is not exhaustive. Wages shown on independent job boards reflect market averages. Memorial Healthcare System is an equal opportunity employer.
#J-18808-Ljbffr