VCU Health · 13 hours ago

Reimbursement Specialist - Ambulatory - Remote

Richmond, VA

Full-time

Remote

Entry Level

1+ years exp

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Responsibilities

Initiate, follow-up, and proceed with approval and/or denials of prior authorizations efficiently via phone, fax, or electronically.

Carry out benefit investigation and coordinate Patient Assistance Programs and/or copay cards for patients with high co-pays or those without insurance coverage.

Work closely with nursing and physicians in order to obtain required documentation for prior authorization and billing.

Arrange refills, transfers, and delivery of medications.

Update patient case management system regularly.

Qualification

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Pharmacy Technician CertificationState Pharmacy LicensePatient Assistance ProgramsPrescription AdjudicationBilling Software ApplicationsPC ProficiencyDisease State TerminologyRecall

Required

Current certification by the Pharmacy Technician Certification Board (PTCB)

Current licensure with the Virginia State Board of Pharmacy

Clean criminal record (i.e. no felony conviction; no drug or pharmacy related convictions, including misdemeanors); no denial, suspension, revocation, or restriction of registration or licensure by any State Board of Pharmacy

Minimum of one (1) year of previous pharmacy practice experience in a similar setting

Minimum of three (3) years of prior experience with Manufacturers Patient Assistance Programs and prior experience with prescription on-line adjudication

Previous work experience using a personal computer and various billing software applications as well as e-mail, spreadsheets, word processing, databases, etc.

High School Diploma or equivalent

Able to work all shifts, weekends, holidays, emergency coverage

Physical: Lifting less than 20 lbs.

Activities: Prolonged standing, Prolonged sitting, Frequent bending, Walking (distance), Climbing (steps, ladder, other), Reaching (overhead, extensive, repetitive), Repetitive motion

Mental/Sensory: Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking

Emotional: Fast pace environment, Steady pace, Able to handle multiple priorities, Frequent and intense customer interactions, Noisy environment, Able to adapt to frequent change