​Pharmacy Benefits Coordinator

Location: Edmond, OK

Pay Rate: $20 - $25 per hour

Join our partner's team in Edmond, OK, as a Pharmacy Benefits Coordinator, where you will be the expert in managing prescription benefits, obtaining authorizations, and providing financial support to patients. Collaborate closely with healthcare providers and clinic staff to ensure patients receive their prescribed medications without unnecessary delays, offering clarity, guidance, and support every step of the way.

Key Responsibilities:

• Prescription Benefits Verification: Accurately verify patient prescription benefits and eligibility, ensuring timely processing.
• Authorization Management: Submit and monitor prior authorizations for medications, ensuring efficient follow-up to prevent delays.
• Insurance Claim Resolution: Reprocess insurance claims for medications as needed, troubleshooting issues with coverage.
• Patient Communication: Provide clear updates to patients regarding their authorization status, outcomes, and any necessary steps to obtain their medication.
• Guidance on Copay Assistance: Direct patients to appropriate copay assistance programs based on their needs.
• Policy Compliance: Stay informed about PBM guidelines, insurance policies, and Oklahoma State Pharmacy Board rules and regulations.
• Issue Resolution: Identify and resolve barriers preventing patients from obtaining prescribed medications.
• EHR Management: Complete assigned tasks in the Electronic Health Record (EHR) system promptly and accurately.
• Support and Collaboration: Maintain strong communication with providers and team members, offering assistance and ensuring smooth operations.
• Confidentiality Adherence: Ensure compliance with HIPAA laws and maintain patient confidentiality at all times.
• Patient Care Excellence: Set a high standard for patient care, ensuring a positive experience for all.

​Your Expertise:

• Pharmacy Knowledge: Strong understanding of prescription medications, their FDA-approved uses, and dosage guidelines.
• Insurance Proficiency: In-depth knowledge of Medicare, Medicaid, Commercial PBMs, and insurance formularies, including step therapy guidelines.
• Authorization Skills: Experience managing pharmacy claim rejections and processing prior authorizations.
• Problem-Solving Abilities: Strong analytical skills to evaluate and resolve errors effectively.
• Pharmacy Math Mastery: Skill in calculating dosages and day supply, with a solid understanding of brand/generic conversions.
• Regulatory Knowledge: Familiarity with Oklahoma State Pharmacy Board rules and regulations.
• Technical Proficiency: Experience with CoverMyMeds, EHR systems, and Microsoft Office Suite (Outlook, Word, Excel, PowerPoint).

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Skills That Set You Apart:

• Exceptional Customer Service: Clear, compassionate communication with patients and providers.
• Analytical Thinking: Ability to assess situations and make informed decisions quickly.
• Organizational Excellence: Capable of prioritizing tasks and coordinating work activities effectively.
• Attention to Detail: High accuracy in data entry and document management.
• Typing Speed: Able to type 50 words per minute.

​Your Must-Haves:

• Experience:
  • 1-2 years of experience in pharmacy billing, insurance, benefits verification, prior authorizations, medical billing, or a related field preferred.
  • 2+ years of experience as a Pharmacy Technician.
  • Specialty pharmacy experience preferred.
  • Liberty system experience is a plus.
• Education: High school diploma or equivalent.
• Licensure: Oklahoma pharmacy technician license required.

Physical Requirements:

• Ability to work efficiently in a fast-paced environment.
• Capable of sitting, performing data entry, and viewing a computer screen for extended periods.

Why Join Our Partners Team?

Our partner in Edmond, OK, is committed to providing exceptional patient support and maintaining high standards in pharmacy benefits coordination. They prioritize clear communication, teamwork, and continuous growth. If you're passionate about making a difference in healthcare and thrive in a supportive, growth-oriented environment, this opportunity is for you.