Beth Israel Lahey Health

Call Center Representative

• Accurately input patient, insurance, and prescription information into the pharmacy system.
• Answer incoming calls and assist callers with non-clinical inquiries and pharmacy-related services.
• Resolve and ensure proper adjudication of claims and contact insurance companies for benefit investigation and coverage eligibility.
• Confirm patient benefits with insurance and determine required authorizations for prescribed therapy.
• Maintain new and existing patient profiles and enter new prescriptions into patient profiles.
• Contact patients to schedule medication deliveries and verify address information.
• Escalate clinical inquiries to pharmacists and grievances to supervisors.
• Ensure patient health information is preserved per HIPAA & PHI guidelines.
• Perform light physical tasks (stand periodically, move around campus) as required.

Specialty Pharmacy Technician, Call Center

Business Analyst

• Complete analysis of medical records within work queues.
• Scan discharge paperwork with 98% accuracy and ensure legibility and accuracy of patient information.
• Verify documentation meets Joint Commission, CMS, DPH regulations, Medical Staff Bylaws, and department procedures.
• Assign deficiencies requiring completion to the appropriate physician within Epic and ensure assignment accuracy.
• Maintain average chart analysis rates (7-10 inpatient charts/hour; 10-12 outpatient charts/hour).
• Keep current with documentation regulations and assist physicians with documentation questions.
• Work collaboratively with physicians to resolve discrepancies regarding deficiency assignment.
• Add all record deficiencies into Epic using the Deficiency Detective resource with 100% accuracy.
• Keep incorrect physician assignment instances under 1% and manage declined and unassigned deficiency work queues.
• Collect 100% of discharge paperwork from patient care areas, run and work chartless deficiencies, and assign NE analyst pool report deficiencies.
• Verify completed deficiencies, investigate and add deficiencies for coding, and assist physicians by attaching to their in-basket.
• Other duties as assigned.

Specialty Pharmacy Technician, Call Center

Health Information Management Analyst