Patient Billing Coordinator

Proclinical is currently recruiting for a Patient Billing Coordinator with a biopharmaceutical company located in North Chicago, IL. Provides best-in-class customer services to patients, Health Care Providers (HCPs) and their staff through referral and call management by investigating patients' insurance benefits and financial assistance opportunities, in addition to processing and monitoring prior authorizations to assist the patient in starting or continuing therapy. This position will be a subject matter expert in insurance billing, claims processing, and prior authorizations. This position liaises between departments, payors, and providers to comprehensively determine patients' overall prescription coverage. The Insurance Analyst I handle patient requests received by phone or electronically (fax, Humira Complete Pro, or other systems) and would complete related outbound calls. This position works collaboratively with other areas of the Pharmacy to maximize patients' access to care.

Job Responsibilities:

• Provide subject matter expertise on medical and prescription insurance coverage/ verification, claim billing, medication prior authorization and appeal filing, and alternate financial assistance opportunities. Accurately documents information in the appropriate systems and formats. Communicate the status of the referral to the physician and the patient via phone, fax, and/or the core pharmacy system as per established policies and procedures.
• Assist offices through the entire documentation and filing process for prior authorizations and appeals. Monitor the status to ensure a rapid turnaround resulting in procurement of the drug product for the patient.
• Use internal and web tools and communicate and collaborate with health insurance payors and providers to investigate pharmacy and medical benefits. Obtain and confirm information to maintain Pharmacy Solutions' payor intelligence resources.
• Meet or exceed department standards relative to performance metrics. Take responsibility and accountability for the day-to-day execution of tasks and is responsible for providing periodic progress reports on goals and metrics.

Skills and Requirements:

• High school diploma or GED equivalent required. Degree preferred.
• 1-3 years of work experience in a healthcare or reimbursement setting; call center preferred.
• Previous experience in a call center environment, healthcare office, corporate setting, or healthcare insurance provider or pharmacy is highly desirable.

If you are having difficulty in applying or if you have any questions, please contact Samantha Reader at 267-536-3075.

ProClinical is a specialist employment agency and recruitment business, providing job opportunities within major pharmaceutical, biopharmaceutical, biotechnology and medical device companies.

Proclinical Staffing is an equal opportunity employer.

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