Financial Coordinator, Pharmacy - Pediatric Specialists of Virginia

Overview

PSV has an exciting employment opportunity for a Specialty Pharmacy Intake Coordinator to work & support PSV’s Gastroenterology Infusion Clinic. This role is working in our Fairfax, VA location. This role is working Full-Time Day Shift 40hrs/week.

PSV offers a comprehensive benefits package: including medical, dental, vision, life, short and long-term disability insurance, 401k plan, holidays, paid time off and a fun work environment. Come join our team! All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran status or status as an individual with a disability.

The Pediatric Specialists of Virginia (PSV) Gastroenterology, Hepatology, and Nutrition team are dedicated to the care of infants, children, and adolescents with stomach, digestive, liver, and nutritional disorders. Our specialists are dedicated to caring only for children, which means we are also specialists in addressing the unique needs of children and families living with these disorders.

Supports PSV’s GI infusion service by coordinating the authorization and delivery of infusion medications provided through health insurance specialty pharmacies. Maintains current knowledge of and adheres to insurance and regulatory guidelines for prior authorization and medical insurance claims processing. Communicates effectively and works cooperatively with patients, providers, nurses, pharmacies and insurance companies. Utilizes standards, guidelines, and written procedures for performing designated functions.

Job Description

• Receives infusion medication orders from PSV providers.
• Identifies and obtains required precertifications, authorizations, and/or referrals and enters all information in the EMR.
• Performs verification of benefits, either electronically or by telephone, according to procedures and guidelines.
• Follows department procedures for documentation.
• Identifies payment source and secures all information required to insure a billable and collectable account and avoid penalties, denials, or bad debt write-offs.
• Advises patients of co-pay assistance programs for infusion medications.
• Coordinates with insurance companies to authorize desired medication and to obtain it from their designated specialty pharmacy.
• Communicates and obtains necessary information from patients/parents.
• Receives calls and respond to questions.
• Arranges for medication delivery, tracks deliveries and receives deliveries.
• Maintains accurate specialty pharmacy logs and updates logs according to department procedures.
• Coordinates with infusion room staff.
• Has a clear understanding of all systems' functionality and uses all systems appropriately.
• Promotes PSV in a positive manner when interacting with patients and practices excellent customer service.
• Elevates issues timely to management. Transfers accounts to the responsible party correctly after completing the necessary due diligence.
• Identifies and seeks out resources to increase knowledge and seek validation of department guidelines and procedures.
• Identifies PSV goals and supports the culture of PSV.
• Displays appropriate behavior when interacting with patients; strives to represent PSV in a positive manner.
• Supports department performance improvement initiatives.
• Assists with data collection in support of quality performance improvement initiatives.
• Other duties as assigned per department requirements.

Minimum Qualifications Required

• High School diploma
• 2-3 years previous experience in Registration/Patient Accounts or Physician Billing Office or Medical Assistant required or combination of experience/education.
  • AA Degree = 1 year; Bachelor's Degree = 2 years.

Desired Qualifications

• Bilingual (Spanish).
• Knowledge of EMRs, computer systems and software applications desired.
• 2 or 4 year college degree preferred.

Physical Demands of Position

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 regularly required to sit, walk and talk or hear; and type on a keyboard. He/she may be required to reach with hands and arms and stoop, kneel, crouch, or crawl; stand, use hands to finger, handle, or feel and climb or balance. The employee may be required to lift and/or move up to fifty (50) pounds. Specific vision abilities required by this job include near vision and distance vision and ability to adjust focus.

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