VCU Health System - MCV Hospitals

Reimbursement Spec (43649168)
Location: Richmond, Virginia - United States
Posted: 11/19/2017

Reimbursement Spec

Full time 7: Rotating High school diploma or equivalent is required

VCU Health System's Specialty Care Pharmacy is seeking a full time Reimbursement Specialist. The Reimbursement Specialist improves revenue collection pertaining to high cost medications that require prior authorization. Will initiate, follow-up, and proceed with approval and/or denials of prior authorizations efficiently via phone, fax, or electronically. Carries out benefit investigation and coordinates Patient Assistance Programs and/or copay cards for patients with high co-pays or those without insurance coverage. Works closely with nursing and physicians in order to obtain required documentation for prior authorization and billing. Arranges refills, transfers, and delivery of medications. Updates patient case management system regularly. Ideally, familiar with disease state terminology or willingness to research. Works as a Pharmacy Technician when deemed necessary.
ResponsibilitiesIdentifies equipment problems; various aspects of assisting the pharmacist that don't require a pharmacist's supervision or check. Qualifications RequiredHigh school diploma or equivalentCurrent certification by the Pharmacy Technician Certification Board (PTCB)Current licensure with the Virginia State Board of PharmacyBy virtue of societal trust and security explicitly imparted to pharmacies for the control of drugs, candidate/incumbent must have a 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 PharmacyMinimum of one (1) year previous pharmacy practice experience in a similar settingMinimum of three (3) years prior experience with Manufacturers Patient Assistance Programs and prior experience with prescription on-line adjudicationPrevious work experience using a personal computer and various billing software applications as well as e-mail, spreadsheets, word processing, databases, etc.Must be available to work all shifts, weekends, holidays, and emergency coverage
PreferredAssociates Degree in Business or related field from an accredited program

Additional Requirments / Information

Job Capacity:Employee (full-time)
Minimum Education Level:See Job Description
Visa Sponsorship: No
Related Industries:Pharmacy Technician
No Profile Available

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