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22 days old

Pharmacy Reimbursement Specialist, Lake Mary, FL

Kelly Services
Lake Mary, FL 32795
**Job Description**


Reimbursement Specialist


Jo Description:


The primary goal of this position is to provide high quality customer service, effectively interface with patients, patient-s families, national payers, home cares and medical doctor-s offices to assist patient and medical provider in expediting the process starting the patient on client product, and ensure the highest level of reimbursement is attained for client product. Extensive knowledge in specialized functions with a wide and comprehensive acquaintance with and understanding of both general and specific aspects of the job and their practical application to complex problems and situations ordinarily encountered. Errors are very difficult to detect and normally require significant expenditures to resolve.


Specific job duties:


Conduct benefit investigations, verify insurance benefits for patient and physicians- office, and submit and obtain prior authorization as required by payer; obtain recertification for cases requiring extended treatment/coverage beyond the expiration of original approval.

Accurately enter and maintain data as required in client database and patient files and utilize the client database to monitor outstanding items on each client case file. Ensure files are complete so team can determine the current status.

Participate in conference calls with Client Sales Representatives, client management and physicians- offices regarding status of cases, drug orders and status of alternative funding.

Provide coordination of order for product, shipment of product, and therapy initiation with pharmacy and patient.

Participate in Call Center Activities, triage and respond to incoming calls from patients, insurance companies, physicians, Sales Reps, pharmacies and homecare agencies. May serve as aingle point of contact for an assigned group of prescribers.

Identify and report events as required by the REMS requirements for specified medication. Recognize adverse event, product quality complaint, potential risk events, and forward information to th e appropriate team member for reporting to the manufacturer.

Educate patients, prescribers, and others regarding program requirements, and facilitate referrals. Maintain good housekeeping techniques, adhering to quality and production standards and comply with all applicable company, state, and federal safety and environmental programs and procedures.


Supervisory Responsibility:

N/A

Desired Skills and Qualifications:

High School Diploma or GED required. Bachelor-s Degree preferred.

4 - 6 years- experience in the insurance, biotechnology, or pharmaceutical industries; customer service and/or reimbursement. Health Insurance claims or patient accounting experience a plus.

Ability to obtain and retain Pharmacy Technician License per state guidelines.

Computer proficiency in MS Office applications, with database experience a plus.

Excellent written and verbal communication skills, with demonstrated ability to communicate with others at all levels.

Ability to manage multiple priorities and meet deadlines.

Detail oriented with good analytical skills.

Knowledge of third party billing, coding, medical terminology, prior authorizations and appeals preferred.

Schedule could be 8 - 5 or 9 - 6 or 11 - 8


**Why Kelly** **** **?**



As a worker today, its up to you to take charge of your career and look for opportunities to learn, grow, and achieve your potential. Helping
you find whats next is what were all about. We know whats going on in the evolving world of workjust ask the nearly 500,000 people we employ
each year. Connecting with us means getting the support, guidance, and opportunities needed to take your career where you may have never imagined.




**About Kelly** ****



At Kelly, were always thinking about whats next and advising job seekers on new ways of working to reach their full potential. In fact, were a
leading advocate for temporary/nontraditional workstyles, because we believe they allow flexibility and tremendous growth opportunities that enable
a better way to work and live. Connecting great people with great companies is what we do best, and our employment opportunities span a wide variety
of workstyles, skill levels, and industries around the world.


Kelly is an equal opportunity employer committed to employing a diverse workforce, including, but not limited to, minorities, females,
individuals with disabilities, protected veterans, sexual orientation, gender identity. Equal Employment Opportunity is The Law.
Posted: 2019-11-22 Expires: 2019-12-23

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Pharmacy Reimbursement Specialist, Lake Mary, FL

Kelly Services
Lake Mary, FL 32795

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