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Specialty Pharmacy Patient Financial Advocate
The University of Kansas Health System. Act as a financial advocate for patients seeking access to specialty prescription medications .
About the role
Key responsibilities & impact- Act as a financial advocate for patients seeking access to specialty prescription medications
- Complete specialty prescription benefits investigations within specified time frames
- Interpret, comply with, and communicate Medicare/Medicaid rules and regulations
- Ensure appropriate billing of specialty prescription medications and complete required insurance authorizations
- Follow up with insurance companies regarding denials and inquiries to resolve accounts
- Seek and apply for copay assistance and manufacturer free-drug programs
- Review patient financial documents and coordinate application materials
- Document activities in the electronic medical record
- Contact patients or families regarding prescription coverage and financial information
- Explain delays and required actions to patients or caregivers
- Resolve billing questions, complaints, denials, insurance changes, claims, and related issues
- Communicate insurance issues with pharmacists and clinic staff
- Participate in continuous improvement and departmental process improvements
- Assist with training new team members
- Process statements, payments, refunds, and adjustments through the point-of-sale system
- Review monthly reports, data, and trends and communicate improvement opportunities to leadership
Requirements
What you’ll need- High School Graduate plus 3 years of experience in specialty pharmacy, medication assistance, prior authorizations, pharmacy benefits investigation, managed care, financial advising, claims processing, collections, or revenue cycle positions; OR an Associate Degree in a related field from an accredited college or university plus 1 year of such experience
- Must be able to type 45 wpm
- Kansas Pharmacy Technician registration within 60 days of hire, including application with the state board of pharmacy
- Strong oral and written communication skills
- Ability to multitask, prioritize, and escalate
- Knowledge of commercial and government insurance
- Ability to navigate payer websites
- Working knowledge of CMS regulations applicable to Medicare Part B and D plans
- Epic experience
- Customer service experience
Benefits
Comp & perks- Equal employment opportunity employer
- Reasonable accommodations for qualified individuals with disabilities