Pharmacy Benefits Specialist

General Summary: A nonexempt position responsible to coordinate the activity of pharmaceuticals, such as Xolair, for the practice. These responsibilities will include: Appointment scheduling; Obtaining prior authorizations; Ordering; Inventory tracking & reconciliation; Collecting patient-due amounts; and other needed tasks

Essential Job Responsibilities:

1. Determine if the pharmaceutical should be handled as Buy & Bill or Specialty Pharmacy
2. Obtain pre-authorization for drug purchase
3. Order pharmaceutical from the drug company
4. Assist patient with copay assistance
5. Provide estimates to patients on their financial responsibility
6. Checks and balances to verify that we are ordering and billing correctly
7. At the end of each day run scheduling and charge reports to ensure that Buy & Bill and Specialty Pharmacy injections have been billed appropriately
8. Collect patient-due amounts
9. Accounts Receivables - follow up, denials monitoring and appeals
10. Monitor and track drug inventory per location
11. Other tasks as requested by supervisor