Enhanced Benefits Coordinator

Enhanced Benefits Coordinator

The Enhanced Benefits Coordinator serves as the hub for prior authorizations associated with key service lines within the medical center as well as health system clinics. This position will obtain and validate insurance and financial information, obtain any required precertification and/or prior authorization for in office administered medications, and provide benefits overviews to patient prior to treatment. This position is responsible for providing front line, direct contact with patients, families, providers, nurses, social workers and pharmacies.

Work Shift: Day (United States of America)

Core Responsibilities and Essential Functions:

• Screens, processes, and completes prior authorization through medical benefits and pharmacy benefits.
• Follows-up with patients, providers, and insurance plans on refills and reauthorizations, as required by payers.
• Processes infusion/injection appointments through AU Health IT platforms in an accurate manner.
• Coordinates with Medication Assistance Coordinators for specialty medications filled through pharmacy benefits or medications accessed through assistance programs.
• Coordinates shipping activities associated with patients own medication to ensure accurate and timely medication delivery.
• Collaborates with other members of the Pharmacy Department team for performance improvement, customer service excellence, and quality assurance (teamwork).
• Performs other duties as assigned
• Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

• High School Diploma General or GED General or Bachelors General-Preferred

Required Minimum License(s) and Certification(s):

• PHT - Registered Pharmacy Tech

Required Minimum Experience:

Minimum 1 year Pharmacy Technician role or in enhanced benefits or similar role in medical office/center, Pharmacy Required or Minimum 2 years Pharmacy Technician role or in enhanced benefits or similar role in medical office/center, Pharmacy Preferred

Required Minimum Skills:

communication skills, organizational skills, prioritization, time management. Microsoft Office proficiency. Proficient with medical terminology. Experience with prior authorizations, insurance, claim adjudication and claim appeals.- Preferred