Reimbursement Coordinator Pharmacy (work from home Eastern Standard Time Zone)

Location:

Work from home (Pennsylvania)

Shift:

Days (United States of America)

Scheduled Weekly Hours:

40

Worker Type:

Regular

Exemption Status:

No

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:

Education:

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

Experience:

Minimum of 3 years-Relevant experience* (Required)

Certification(s) and License(s):

Skills:

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, we encourage an atmosphere of collaboration, cooperation and collegiality.

We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all.  We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.