What we are looking for
Optime Care seeks a Pharmacy Technician, also called a Care Coordinator, for our Berwyn, PA, location. We are looking for someone who is passionate about helping people get the specialized therapies they need. This critical role serves as the first point of contact and manages patient communications with regular follow-ups required to coordinate the delivery of medications and billing and collecting from the payer. They work with patients as an advocate and guide and coordinate with the Optime Care team through the entire care continuum.This position will be required to be in the office 5 days a week, Monday through Friday, for the first 120 days for training purposes.
After that, it can evolve into a hybrid role with 3 or 4 days in-office required depending on business needs.The job details
- Act as a patient advocate to gain insurance coverage for prescribed therapies.
- Conduct periodic insurance verification and/or authorizations for patient coverage.
- File claims for patient prescriptions and orders.
- Complete collection activities per client program specifications.
- Provide an initial and ongoing investigation and benefit explanation to the patient.
- Obtain and maintain Prior Authorizations.
- Bill for Rx (or “prescription” might be better) drugs and administration supplies.
- Assist patients with possible financial assistance.
- Arrange all necessary documents and materials for initial and ongoing shipments.
- Coordinate all deliveries and process any patient returns.
- Obtain necessary consent forms for manufacturers or patient support organizations.
- Assist in preparing any ad hoc report request from clients.
- Perform other related duties as assigned or necessary; remain flexible and adaptable in work schedules and assignments as defined by departmental and organizational needs.
Necessary Skills, Education & Abilities
- A high school diploma or equivalent is required.
- 2 or more years of experience with medical/pharmacy insurance verification, including benefit investigation.
- A current Missouri BOP Pharmacy Technician license or the ability to get one.
- Knowledge of medical terminology is required.
- Knowledge of medical/pharmacy insurance benefit language such as EOBs, deductibles, out-of-pocket, co-insurance, co-pays, etc.
- Ability to define CMS 1500s, provider numbers, CPT, HCPC’s, ICD9, NCPDP and NDC codes/numbers.
- Knowledge of Medicare and Medicaid billing.
- Patient Assistance Program knowledge a plus.
- Experience with prior authorization and SMN preparation.
- Knowledge of insurance claim appeals.
- Computer literate and proficient with Microsoft Office. CPR+ and/or CareTend experience is preferred.
- Relentless attention to detail and the ability to be a creative self-starter and team player.
- Ability to participate in and facilitate group meetings.
- Ability to thrive in a fast-paced environment with constantly changing and competing priorities.
- Excellent analytical skills and the ability to provide solutions to complex problems.
- Ability to be highly transparent, ethical, and driven.
- Excellent written and verbal communication skills, also? interpersonal skills required.
- Willingness to work a flexible schedule to support different time zones across the country.
About usOptime Care is a Specialty Pharmacy dedicated to providing services to smaller patient communities. We focus on securing insurance coverage, coordinating care, and complying with therapy regimens are only a few examples. Our mission is to minimize the daily impact of living with unique disorders. After just one call, our experts begin to address everything from medication delivery and insurance reimbursement to compliance and education. Every patient receives a proactive service experience tailored to their specific needs.AscellaHealth provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
