Insurance Coordinator - Specialty Pharmacy

What we are looking for Optime Care is seeking an Insurance Coordinator. We are looking for someone who is passionate about helping people get the specialized therapies they need. This critical role will assist uninsured and underinsured patients in obtaining insurance coverage. They will assess each patient’s overall healthcare needs and explain coverage options available to them in their area. patient advocates to guide patients through the process of obtaining pharmaceuticals not available through chain pharmacies. This position is eligible to become a hybrid role, with the opportunity to work remotely 1 or 2 days per week after an introductory period, depending on business needs. The Job Details Communicate directly with patients to evaluate their specific needs and to assess insurance options. Act as a patient advocate to gain insurance coverage for prescribed therapies. Recommend insurance policies to patients by evaluating their needs. Investigate and explain benefit plans and details to the patient. Keep up-to-date with developments in the insurance market, staying informed of industry trends and changes. Maintain accurate records of patient interactions within the pharmacy management system. Collaborate and strategize with team members regarding patient cases. Provide day-to-day communication on patient case statuses between team members. Assist patients with financial assistance resources. Assist with preparing any ad hoc client report requests. Monitor external websites relating to therapy areas, specifically around coverage updates or changes. Monitor system payers for appropriate and complete information. Other duties as needed or assigned by the business. Necessary Skills, Education & Abilities A high school diploma or equivalent is required. A college degree, Associate's or Bachelor's, is preferred. 2 or more years of experience with medical/pharmacy insurance claims, billing, and/or benefit investigation. Extensive knowledge of state Medicaid plans, Medicare Part D plans, and ACA plans. Knowledge of medical/pharmacy insurance benefit language; ie. EOB’s, deductibles, out-of-pocket, coinsurance, co-pays, etc. Knowledge of medical terminology and diagnosis codes is helpful. Missouri Pharmacy Technician license or willingness to obtain one once employed. Knowledge of Medicare and Medicaid billing Patient Assistance Program knowledge a plus Computer literate and proficient with Microsoft Office. Ability to participate in and facilitate group meetings. Ability to thrive in a fast-paced environment with constantly changing and competing priorities. Excellent analytical skills and the ability to provide solutions to complex problems. Ability to be highly transparent, ethical, and driven. Relentless attention to detail, and the ability to be a creative self-starter and team player. Excellent written and verbal communication skills, and interpersonal skills required. Willingness to work a flexible schedule. Ready to make an impact? Join us on our mission to transform specialty pharmaceutical services and improve patient lives. We’re looking for passionate professionals who share our commitment to excellence and innovation. Apply today and become part of a team that’s shaping the future of healthcare. About Us Optime Care is a Specialty Pharmacy dedicated to providing services to smaller patient communities. We focus on securing insurance coverage, coordinating care, and complying with therapy regimens are only a few examples. Our mission is to minimize the daily impact of living with unique disorders. After just one call, our experts begin to address everything from medication delivery and insurance reimbursement to compliance and education. Every patient receives a proactive service experience tailored to their specific needs. Optime Care provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

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