Job Description

Job Location: Shelby - Shelby, NC 28150
Position Type: Full TimePharmacy Benefits Specialist

General Summary: A nonexempt position responsible to coordinate the activity of pharmaceuticals, such as Xolair, for the practice.  These responsibilities will include: Appointment scheduling; Obtaining prior authorizations; Ordering; Inventory tracking & reconciliation; Collecting patient-due amounts; and other needed tasks

Essential Job Responsibilities:
- Determine if the pharmaceutical should be handled as Buy & Bill or Specialty Pharmacy
- Obtain pre-authorization for drug purchase
- Order pharmaceutical from the drug company
- Assist patient with copay assistance
- Provide estimates to patients on their financial responsibility
- Checks and balances to verify that we are ordering and billing correctly
- At the end of each day run scheduling and charge reports to ensure that Buy & Bill and Specialty Pharmacy injections have been billed appropriately
- Collect patient-due amounts
- Accounts Receivables - follow up, denials monitoring and appeals
- Monitor and track drug inventory per location
- Other tasks as requested by supervisor

QualificationsEducation: High school diploma or equivalent.

Experience: At least 1 year of insurance verification, and charge auditing

Other Requirements: None
Performance Requirements:
Skills:
- Ability to multi-task
- Attention to detail
- Ability to read accounts and understand medical terms
- Excellent customer service and communication skills
- Exhibit high level of professional behavior
- Ability to learn quickly and work well under pressure
- Ability to work independently and as a team
Equipment Operated: Standard office equipment including computers, fax machines, copiers, printers, telephones, etc.

Work Environment: Position is in a well-lighted office environment.
Mental/Physical Requirements: Involves sitting approximately 90 percent of the day, walking or standing the remainder.