Pharmacy Care Coord
BayCare Health System - largo, FL
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At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that's built on a foundation of trust, dignity, respect, responsibility and clinical excellence. Summary: Responsibilities include the following: processing new referrals, verify all necessary information is included in the referral, entering new referrals and updates all existing patient information (insurance information, patient demographics benefit information) into the corporate IS systems; verify all referrals meet all regulatory, payer, and safety requirements; create pharmacy packets; communicates information to the referral source and patient and/or caregiver on all deliveries to confirm address, patient responsibilities for co-payment and co-insurance. Verifies insurance and benefits for all Medicare, Managed Care, and Private Fee for Service Plans. Responsible for selecting the correct payer and diagnoses codes. Understands medical criteria for securing all required information from the referral source. Responsible for entering the appropriate financial information including benefits, deductibles, co-pays, coinsurance, out of pocket into the EHR. Responsible for timely requests and communication of authorizations to payer and documentation in EHR. Additional responsibilities include advising patient and referral source on Medicare and Managed Care guidelines and reimbursement issues as needed, performs ICD-10 coding of referrals and other duties as assigned. Timely response to referral sources, providers, and leadership is essential. Monitors and communicates referral source activity acting as one point of contact for referral sources, home health, and home infusion. Minimum Qualifications: Other information: Required Education: HS Graduate or Equivalent GED Preferred Experience: 2 years Infusion Related, 1 year Insurance Verification and 1 year Pharmacy Related Computer proficiency in Microsoft Office and Excel is preferred. Education: Essential: Education Information in Comments Experience: Nonessential: Reference Other Information in Summary Facility: BayCare Health System, Infusion Services-HC Location: HomeCare Largo Status: Full Time, Exempt: No Shift Hours: 8am-5pm or 9:30am-6:30pm M-F Shift: Shift 1 Shift 1 = Days, 2 = Evenings, 3 = Nights, 4 = Varies Weekend Work: Occasional On Call: No How often will this team member be working remotely? Never Equal Opportunity Employer Veterans/Disabled Position Pharmacy Care Coord Location US:Florida:Largo:HomeCare Largo | Clinical | Full Time Req ID null
Created: 2024-07-07