Operations Oversight Analyst
Gold Coast Health Plan
Claims Analyst
PANTHERx Rare Pharmacy
full-time
Posted on:
Origin: • 🇺🇸 United States • Pennsylvania
Visit company websiteJob Level
JuniorMid-Level
About the role
- Verifies patient pharmacy and medical coverage & processing info.
- Process pharmacy claims on the patient’s behalf through a pharmacy benefit system.
- Verify medical benefits accurately on patient’s behalf.
- Obtain authorizations & overrides as needed.
- Applies patients for copay cards and/or assistance programs.
- Discuss with patient to review patient financial responsibility, obtain patient consent and payment.
- Ensures proper shipment set up.
- Works special projects.
- Attends staff meetings.
- Other tasks as assigned.
Requirements
- High school diploma or general education degree (GED).
- Minimum 2 years’ experience processing pharmacy claims.
- Strong written and verbal communication skills necessary to convey ideas professionally and effectively.
- Ability to multitask.
- Proficient with EDS billing systems, Excel, and Word.
- Experience or knowledge within the healthcare industry, particularly a mail order or specialty pharmacy (preferred).
- Experience with CPR+ (preferred).
