Job Description:
Responsible for performing prior authorizations; collaborating with the pharmacies, third parties, and software vendor to work through claims adjudication and processing issues to ensure payment from commercial and government payers for medications ordered needing pre-certification (medical necessity) and/or prior authorizations according to the health or pharmacy plans. Work Experience: 2 years' experience as a pharmacy technician, medical assistant, or in a coding role Responsible for performing prior authorizations; collaborating with the providers, pharmacies, third parties, and software vendor to work through claims adjudication and processing issues to ensure payment from commercial and government payers for medications ordered needing pre-certification (medical necessity) and/or prior authorizations according to the health or pharmacy plans. Will assist in Medicare part B billing and processing for Essentia Health Pharmacies. Also, will assist in Pharmacy Patient Assistance Program including working directly with patient to file applications and re-enrollments and assist in refilling assistance medications. Work Experience: 2 years' experience as a pharmacy technician, medical assistant, or in a coding role Excellent verbal and written communication skills required; Attention to detail. Ability to multi-task. Strong interpersonal skills, including verbal and written communication. Ability to communicate with patients, physicians, and a variety of other personnel. Ability to work independently.
Education Qualifications:
No educational requirements.
Licensure/Certification Qualifications:
CMA, Pharmacy Technician, Coding, LPN - applicable to the education of specific position above.
FTE
1
Shift Rotation
Day Rotation (United States of America)
Shift Start Time
0800
Shift End Time
1630
Pay Range
$17.73 - $26.60 / hour
The approximate base compensation range is posted, but the actual offer will reflect our total compensation and benefits package. The offer will be determined by a number of factors including the selected candidate's experience, knowledge, skills, abilities, FTE, as well as internal equity among our team.
Effective December 1, 2019: Job offers are contingent upon successful completion of a post-offer assessment, including a urine drug screen, immunization review, proof of required vaccinations, and background check. Essentia Health is committed to maintaining a work environment free from the influence of illegal drugs and alcohol.
Essentia Health EEO:
Essentia Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, sexual identity, national origin, disability, protected veteran status, or any other characteristic protected by law.
Equal Employment Opportunity (EEO) at Essentia
It is our policy to afford EEO to all individuals, regardless of race, religion, color, sex, pregnancy, gender identity, national origin, age, disability, family medical history, genetic information, sexual orientation, marital status, military service or veteran status, culture, socio-economic status, status with regard to public assistance, and other factors not related to qualifications, including employees or applicants who inquire about, discuss, or disclose their compensation or the compensation of other employees or applicants, or membership or activity in a local human rights commission, or any other category as defined by law.
