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Reimbursement Coordinator Pharmacy

Geisinger

Details

Posted:

March 17, 2021

Location:

Wilkes-Barre, Pennsylvania

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Salary:

Open

Type:

Full Time

Discipline:

Operations

Job Summary

Serves as a liaison regarding the reimbursement, replacement, or provision of free medications to patients utilizing medication assistance programs for the uninsured, under-insured, indigent and for those who have exceeded their maximum level of insurance coverage. Monitors high cost medications for appropriate reimbursement. Communicates to the appropriate ambulatory and inpatient personnel billing codes for new medications as they are added to the formulary. Serves as a resource regarding eligibility criteria, enrollment requirements and contacts for all pharmaceutical manufacturer's medication assistance programs.

Job Duties

Develops and implements the medication assistance program for eligible patients.
Learns and understands the eligibility criteria and enrollment requirements of the various pharmaceutical companies' medication assistance programs.
Maintains knowledge of various information resources available regarding pharmaceutical company-sponsored medication assistance programs.
Serves as a liaison regarding medication assistance programs.
Provides assistance to the customer regarding the completion of the proper paperwork for enrollment in the program.
Communicates to the various customers the outcome of a patient's application for medication assistance and coordinates the resolution of the patient's account with appropriate business service coordinator regarding drug charges.
Assists with the communication of new billing codes to the appropriate people as new medications are added to the formulary.
Reviews and analyzes patient financial service reports to ensure correct coding, correct reimbursement, or the need to investigate appropriate indigent care programs.
Monitors high-cost, targeted medications to ensure appropriate reimbursement.
Communicates with appropriate business service personnel to help resolve issues that arise.
Educates other healthcare providers and ancillary service personnel on current reimbursement issues regarding medications that are part of the medication assistance program.
Maintains a database of the local pharmaceutical representatives and the medication assistance programs available.
Completes, updates and corrects database files for all patients interviewed.
Reports monthly results of all patients interviewed as to their results.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. *Relevant experience may be a combination of related work experience and degree obtained (Associate's Degree = 2 years; Bachelor's Degree = 4 years).

Position Details

Currently weekends and holidays are not included in the schedule.

Education

High School Diploma or Equivalent (GED)- (Required)

Experience

Minimum of 3 years-Relevant experience* (Required)

Certification(s) and License(s)

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.* Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.

We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.

Internal Number: R-10891

About Geisinger

At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh FoodFarmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencingprograms, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13... hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers. What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.

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