Amerita

This role will be responsible for verifying patient medical and pharmacy coverage, investigating authorization requirements, and facilitating patient copay card assistance based on eligibility criteria. The Senior Benefits Investigation Specialist will be a subject matter expert.

• Verifies patient prescription benefits, including medical and pharmacy coverage, to ensure accurate billing and reimbursement
• Investigates authorization requirements for medications and any ancillary supplies, collaborating with healthcare providers and insurance companies as necessary
• Determines patient eligibility for copay card assistance programs based on program criteria and facilitate enrollment as appropriate
• Knowledgeable to perform all Benefit Investigation functions. Provides thorough, accurate and timely responses to requests
• Leads team efforts to regularly assess performance based on various metrics – daily, weekly, monthly reports
• Regional subject matter expert
• Ability to train, test and evaluate others in all essential position responsibilities for proficiency as directed by the manager
• Performs audits to ensure accuracy with all GSI standards as directed by manager
• Drives performance/process improvements through support and training

 

 

EDUCATION/EXPERIENCE
• Education/ Learning Experience: High School Diploma or GED or licensed/registered pharmacy technician or previous experience in Pharmacy.
• Work Experience: 1+ years pharmacy experience.

 

KNOWLEDGE/SKILLS/ABILITIES
• Pharmacy or healthcare-related knowledge.
• Knowledge of pharmacy terminology including sig codes, and Roman numbers, brand/generic names of medication.
• Basic math and analytical skills.
• Intermediate typing/keyboard skills.
• Communicate clearly and professionally, both in written form and orally with internal and external customers.
• Available to work extended hours when necessary to meet department deadlines.

 

Working Conditions
Occasional weekend, evening or night work if needed to ensure shift coverage

 

 

**This position will require sitting and typing on a keyboard with fingers constantly, and occasional standing, walking, and bending. The physical requirements will be the ability to push/pull and lift/carry 21-30 lbs.**

Amerita is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness and entrepreneurial spirit of a local provider. For more information about Amerita, please visit www.ameritaiv.com. Follow us on Twitter and LinkedIn.