Job Description

Job Title: Lead, Insurance Verification Coordinator, Chartwell
Job ID: 80325402
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Community Provider Svcs
Department: Reimbursement
Location: 1001 Oakdale Road, Oakdale PA 15071

Description

Purpose:
Under the supervision and direction of the Manager, Billing, the Lead, IVC-CWSP will be responsible for the daily functions of the Insurance Verification and Customer Service area for Chartwell - Specialty Pharmacy including verification of insurance coverage, entering and updating patient demographics into the computer system, communication of financial responsibility, securing financial assistance for patients, generating orders and delivery tickets and patient calls and assessments. The Lead, IVC-CWSP is responsible for training, updating and monitoring the performance of the Chartwell - Specialty IVC staff and will also, create and update policy and procedures and training guides specific to the Chartwell - Specialty Pharmacy reimbursement department.

Responsibilities:
  • Demonstrates the ability to work effectively and maintain expected productivity.
  • Enters and updates patient demographics into computer system. Verifies and enters new physicians into computer system as needed.
  • Prioritizes and completes work on schedule.
  • Verifies patients' insurance benefits and obtains prior authorizations as required for specialty pharmacy therapies prior to start of care.
  • Carries out all responsibilities in accordance with Chartwell's Core Values.
  • Responsible for training, updating and monitoring the performance of the Specialty IVC staff.
  • Cooperates with other staff members when planning and organizing daily activities.
  • Track, monitor and secure clinical, reimbursement and financial documentation based upon company requirements.
  • Utilizes appropriate communication lines in relaying problems, concerns, questions and ideas.
  • Processes delivery slips for new and refill patient orders. Coordinates/schedules deliveries of patient orders with pharmacy operations.
  • Creating and updating policy and procedures and training guides specific to the specialty pharmacy reimbursement department.
  • Maintains courteous demeanor at all times.
  • Other duties as assigned or needed by Manager.
  • Demonstrates reliability and follow-through on all assigned tasks.
  • Reviews financial responsibility with patient or family member and obtains payment mechanism.
  • Takes initiative to present ideas/suggestions to management.
  • Communicates verbally with patients, caregivers and determines specific patient supply needs as well as patient assessment data and follow-up for pharmacist review.
  • Researches and assists patients with co-pay assistance programs. Tracks and generates reports for management specific to co-pay assistance obtained.
  • Demonstrates ability to communicate effectively and express ideas clearly.
  • Sets high goals or standards of performance for self.

Qualifications

  • Associate's degree required
  • 3-5 years of experience in Specialty Pharmacy or home IV therapy insurance verification and/or billing/collections required 
  • Customer service experience required
  • Pharmacy (NCPDP) billing/collections and/or insurance verification highly preferred
  • Knowledge of financial assistance programs preferred
  • Basic Computer skills and Microsoft Office Products experience preferred
  • Excellent organizational, communication and customer service skills
  • Capable of managing multiple priorities

Licensure, Certifications, and Clearances:
  • Act 34

  • UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

    Salary Range: $18.79 to $31.23 / hour

    Union Position: No

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