Location: Magnolia,TX, USA
Adecco is partnering with a leading distributor of Oncology and specialty medications in the recruitment of a Pharmacy Benefits Intake Specialist in **The Woodlands, Texas.**
**Requirements:**
2-3 years of pharmacy/healthcare benefits coordination experience.
Experience submitting prior authorization requests and verifying eligibility for medical benefits.
**Must reside within reasonable driving distance from The Woodlands, Texas.**
Experience obtaining authorization for injectable/infusion medications.
EPIC EMR Experience highly preferred
High School diploma or equivalent
Experience with reimbursement practices, including government program regulation and managed care contracting.
Intake/patient access experience.
Excellent personal computing skills and a working knowledge of MS Office software.
Must be able to communicate effectively, both orally and in writing.
**Work Schedule:** (M-F 7a-6p)
**Pay Rate** -The anticipated wage for this position is between $ $22 and $23.
Hourly wage depends upon experience, education, geographic location and other factors.
**Location** - Remote after training. Must reside within reasonable driving distance from THe Woodlands, Texas.
**Job Duties:**
Verifies insurance benefits for new patient referrals and re-verifies existing patient benefits as policy indicates. Obtains pre-certifications, pre-determinations, and authorizations for services per insurance guidelines. Evaluate the profitability of therapies and communicate issues.
**Essential Functions and Duties**
o Manage work queue to department standards for productivity and quality.
o Verifies insurance benefits for new patient referrals.
o Re-verifies insurance benefits for existing patients.
o Accurately evaluates charge and reimbursement estimates for infusion therapies.
o Reviews all medical documentation against medical policy and initiates/obtains pre-determination, pre-certification, and authorizations as needed.
o Follow-up on pending pre-certifications and/or pre-determinations until the outcome is decided.
o Updates and maintains insurance and authorization information in the billing software.
o Obtains PCP referrals as needed.
**Pay Details:** $22.00 to $23.00 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
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+ The California Fair Chance Act
+ Los Angeles City Fair Chance Ordinance
+ Los Angeles County Fair Chance Ordinance for Employers
+ San Francisco Fair Chance Ordinance