With more than two decades of experience, Omnicare works to deliver practical and innovative solutions to address our customer's needs both now and in the future.
Omnicare is the nation's leading provider of pharmaceutical care for seniors. Each day, our pharmacists serve more than 1.4 million residents of skilled nursing, assisted living, and other healthcare facilities in 47 states and Canada. While doing this, we capture a tremendous amount of data. Omnicare combines this data with its proprietary outcomes algorithm technology, based on best practices in geriatric medicine, to identify and help treat diseases in the elderly.
Reimbursement Specialist I
Job Summary: This position obtains reimbursement information for patients and providers by calling payers and triaging to the correct specialty pharmacy provider for services. In addition, the position provides product and service information in reference to product support, and answers general questions about the program and the products. Responsible for documenting required data elements into required fields in a prompt accurate manner based on program design and requirements. Works with internal departments at all levels to ensure smooth customer service operations and satisfactory resolution of customer requests
Shift: 11:30 AM - 8 PM. Monday - Friday.
- Secure insurance policy benefit information for government, commercial and third party insurance carriers and specialty pharmacy/retail pharmacy
- Seek reimbursement information from Medicare, Medicaid and Commercial plans
- Provide reimbursement information to the physician office, the patient and to the PAP Specialist.
- Provide benefit information and refer applicants about co-pay assistance programs
- Send statement of benefits to patients and physician.
- Maintain all patient confidentiality per HIPAA regulations
- Manage tickler on a daily basis to keep within program contract constraints
- Serve as patient/physician advocate in securing insurance verification and benefits for drug therapies
- Obtain prior authorizations when allowed per insurance constraints
- Able to handle multiple calls within a phone queue
One to Three years experience working in a healthcare environment
- High School Diploma or equivalent
- Knowledge of Medical Terminology
- Ability to express ideas clearly both written and oral communications
- Ability to enter data correctly
- Strong attention to detail and ability to handle multiple tasks well
- Strong computer skills required; preferably Microsoft Word or Excel software applications
- Data entry skills required
- Ability to read and interpret documents such as safety rules and procedure manuals
- Ability to resolve problems independently
- Ability to speak effectively before groups/customers or employees of an organization
- Ability to carry out instructions furnished in written, oral or diagram form
- Adaptable to changing priorities as needed
Physical Demands: May sit, stand, stoop, bend and walk intermittently during the day. May sit or stand seven (7) to ten (10) hours per day. May be necessary to work extended hours as needed. Finger dexterity to operate office equipment required. May need to lift up to twenty-five (25) pounds on occasion. Visual acuity to see and read fine prints. Specific vision abilities required by this role include close vision, color vision and the ability to adjust focus. Must be able to hear normal voice sounds. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role.
Work Environment: Work in a climate-controlled, smoke-free internal environment.