Job Description

About AmeriPharma

AmeriPharma is a rapidly growing healthcare company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves.

AmeriPharma’s Benefits

• Full benefits package including medical, dental, vision, life that fits your lifestyle and goals
• Great pay and general compensation structures
• Employee assistance program to assist with mental health, legal questions, financial counseling etc.
• Comprehensive PTO and sick leave options
• 401k program
• Plenty of opportunities for growth and advancement
• Company sponsored outings and team-building events
• Casual Fridays

As an Insurance Coordinator at AmeriPharma, you will be responsible for accurately and efficiently verifying patients' medical insurance coverage and obtaining required prior authorizations. This role helps ensure timely access to care while supporting appropriate reimbursement for services. You will work closely with insurance providers, patients, and internal teams to facilitate the authorization process, resolve coverage-related issues, and maintain accurate documentation to support prompt and compliant payment.

Duties and Responsibilities

• Review and prioritize incoming orders requiring benefits investigation and medical prior authorization to ensure timely processing.
• Verify that patient insurance information is accurate, complete, and up to date within patient profiles.
• Contact insurance carriers to verify eligibility and benefits, including plan type, coverage limits, deductibles, exclusions, authorization requirements, and covered services.
• Accurately document all interactions with insurance representatives, including representative names, reference numbers, call details, and outcomes.
• Communicate insurance restrictions, coverage limitations, prior authorization requirements, and reimbursement concerns to the appropriate internal team members to support continuity of care and timely service.

• Perform additional duties and provide cross-functional support within the department as needed or as assigned by management.
• Promote a culture of accountability, integrity, collaboration, and service excellence while contributing to a positive and team-oriented work environment.

Required Qualifications

• Proficient in English, including reading, writing, and verbal communication.
• Strong collaboration and interpersonal skills, with the ability to work effectively with team members and management.
• Excellent time management, organizational, and communication skills.
• High attention to detail with accurate data entry and minimal typing errors.
• Ability to work independently, prioritize tasks, and consistently meet deadlines in a fast-paced environment.
• Working knowledge of medical terminology, including ICD-10, CPT, and HCPCS coding.
• Familiarity with managed care, commercial insurance, Medicare, Medicaid, and insurance reimbursement processes.
• Proficient in Microsoft Word and Excel.
• Strong analytical and problem-solving skills with the ability to interpret insurance and reimbursement data effectively.
  

Preferred Qualifications

• Experience in medical billing, coding, or insurance verification, with a strong understanding of managed care, commercial insurance, Medicare, and Medicaid reimbursement.
• Working knowledge of medical terminology, ICD-10, CPT, HCPCS, and J-codes, as well as CMS-1500 (HCFA-1500) claim forms and electronic billing processes.
• Experience conducting benefit investigations, verifying insurance eligibility, and explaining patient financial responsibility and Patient Responsibility Agreements.
• Proficiency with electronic billing systems and insurance payer portals, including Availity and Noridian, for eligibility verification and benefits investigation.
• Advanced proficiency in Microsoft Word, Excel, and Outlook.
• At least one year of pharmacy experience, preferably in a specialty, infusion, or healthcare setting.

AmeriPharma’s Mission Statement

Our goal is to achieve superior clinical and economic outcomes while maintaining the utmost compassion and care for our patients. It is our joint and individual responsibility daily to demonstrate to outpatients, prescribers, colleagues, and others that We Care!

Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is continuously required to sit and talk or hear. The employee is occasionally required to stand; walk; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; and stoop, kneel, crouch or crawl. The employee must regularly lift and/or move up to 20 pounds and occasionally lift/or move up to 30 pounds. Specific vision abilities required by this job include close vision, peripheral vision, depth perception and the ability to adjust focus.

EEO Statement

The above statements are intended to describe the work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties and skills required. The duties and responsibilities of this position are subject to change and other duties may be assigned or removed at any time. AmeriPharma values diversity in its workforce and is proud to be an AAP/EEO employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, sexual orientation, gender identity, national origin, age, protected veteran status, or based on disability or any other legally protected class.