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VCU Health System Reimbursement Spec in Richmond, Virginia

Reimbursement Spec

Req. #:

66116

Department:

IM-DALTON ONCOLOGY CLINIC

Location:

1300 E. Marshall Street, Richmond, VA 23219

Schedule:

Full time

Shift:

1: Days

Hours:

Job Details:

  • JOB SUMMARY

  • The chief objective of this position:

  • To improve 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.

  • Licensure, Certification, or Registration Requirements for Hire:

  • Current certification by the Pharmacy Technician Certification Board (PTCB)

  • Current licensure with the Virginia State Board of Pharmacy

  • By 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 Pharmacy

  • Licensure, Certification, or Registration Requirements for continued employment:

  • Current certification by the Pharmacy Technician Certification Board (PTCB)

  • Current licensure with the Virginia State Board of Pharmacy

  • Experience REQUIRED:

  • Minimum of one (1) year previous pharmacy practice experience in a similar setting

  • Minimum of three (3) years prior experience with Manufacturers Patient Assistance Programs and prior experience with prescription on-line adjudication

  • Previous work experience using a personal computer and various billing software applications as well as e-mail, spreadsheets, word processing, databases, etc.

  • Education/training REQUIRED:

  • High School Diploma or equivalent

  • Education/training PREFERRED:

  • Associates Degree in Business or related field from an accredited program

#LI-DB2

EOE/M/F/Vet/Disabled

Qualified applicants will receive consideration for employment without regard to their protected veteran or disability status.

HR Use Only:

PTO

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