Pharmacy Reimbursement Specialist

Job Description

Job Description

The Reimbursement Specialist will ensure that Beaufort Memorial Hospital is obtaining the appropriate and highest reimbursement for claims for drugs ordered and administered in the outpatient infusion centers. The incumbent will have a comprehensive approach to drug and agent ordering, insurance verification, pre-authorization, guidance for appropriate product selection and claim reconciliation. This person will follow up on claim adjudication to include claim rejects, underpayments and appropriate reimbursement to respective payer contacts. This person may also work on co-pay and drug reimbursement cards, which may be available to the patient to minimize out of pocket costs. This position will work closely with Prescribing Physicians, Nurse Practitioners, Pharmacy, Finance, Pre Authorization, Infusion and Oncology staff. This position will report directly to Pharmacy Leadership with a dotted line to Finance and Oncology leadership in a highly matrixed setting.