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Insurance Claims / Policy Clerk
Livingston, NJ
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Asembia is seeking driven and friendly Prior Authorization Pharmacy Technician for our organization. Our teams are comprised of passionate and motivated professionals; and through collaborative programs, contracting initiatives, patient support hub services and innovative technology platforms, Asembia is committed to positively impacting the patient journey. We offer our employees the latitude required for professional growth and career advancement. Minimum of 1 year pharmacy experience required.
Required shift may vary:
The pharmacies operating hours are 8am - 11pm EST Monday through Friday, and Saturday through Sunday 8a-8p EST.
Primary Function:
The incumbent is responsible for executing program requirements, managing daily workflow, providing accurate and complete data input, managing pre-certifications, and providing high levels of customer service.
Job Scope and Major Responsibilities:
Complete prescription intake process including verification of insurance coverage Assist physician's offices through the prior authorization and appeals process Research financial assistance options for patients through copay cards, foundations, and assistance programs Coordinate prescription processing and delivery with dispensing pharmacies Manage and triage high volume of customer service phone calls while managing day to day operations Build relationships with physicians, manufacturer sales representatives, pharmacies, patients, and other team members to optimize workflow and achieve program goals Ensure proper documentation of process flow from prescription initiation through completion Provide timely updates to physicians, pharmacies, and manufacturers regarding prescription status Interface with IT department to improve system functionality and workflow Attend team meetings to support ongoing program development Other responsibilities as assigned Success in this position is defined by high levels of customer service and timely processing of prescriptions through all phases Compliance with the provisions of the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations, as amended ("HIPAA")
Performance Criteria:
Performance in this role is measured by accurate and timely routing of referrals and reporting as well as high levels of customer service.
Required Qualifications:
National Certified Pharmacy Technician highly desired Minimum of 1 year pharmacy experience required Minimum 3 years of
PRIOR AUTHORIZATION
experience is
REQUIRED
Previous work experience in a call center environment or customer service role preferred General knowledge of pharmacy laws, practices and procedures Knowledge of common medical terms/abbreviations and pharmacy calculations Understanding of insurance and third-party billing systems Skill to prioritize and work in a fast-paced environment Exemplary communication, organization, and time management skills Capability of working independently and as a member of a team Ability to preserve confidentiality of protected health information (PHI) Proficient in MS Word, Excel and Outlook Possess and maintain professional demeanor and courteous attitude Join our team! If you feel you are the right fit for this role, please apply. We look forward to speaking with you further about working with Asembia.
About Us:
For more than a decade, Asembia has been working with specialty pharmacies, manufacturers, prescribers, and other industry stakeholders to develop solutions for the high-touch specialty pharmaceutical service model. Asembia focuses on the specialty pharmacy segment and offers comprehensive hub services, pharmacy network management, group purchasing (GPO) services, innovative technology platforms and more. As a leading industry voice and advocate, Asembia is committed to bringing strategic channel management solutions, leading-edge products and high-touch services to the specialty pharmacy industry that help our customers optimize patient care and outcomes. Asembia is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, gender identity and expression, citizenship, genetic disposition, disability or veteran's status or any other classification protected by State/Federal laws.
Job Type:
Full-time Pay:
$17.00 - $20.00 per hour
Benefits:
401(k) Dental insurance Health insurance Life insurance Paid time off Vision insurance Application Question(s): What are your pay rate expectations? How many years of experience do you have in prior authorization? How many years of experience do you have in a call center environment? Ability to
