Enhanced Benefits Coordinator WMCG

locationsAU Medical Center, Inc.

time typeFull time

posted onPosted 30+ Days Ago

job requisition idJR-40844

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful : to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Job Summary :

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.

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) :

All certifications are required upon hire unless otherwise stated.

Additional License(s) and Certification(s) :

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

Join us and discover the support to do more meaningful work—and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.