Clinical Appeals Coordinator
bioplus specialty pharmacyAltamonte Springs, FL
Clinical Appeals Coordinator
bioplus specialty pharmacyAltamonte Springs, FL
10 days ago
Occupations
Medical Secretaries and Administrative AssistantsPatient RepresentativesMedical Records SpecialistsIndustries
Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension FundsAll Other Outpatient Care CentersPharmaceutical Preparation ManufacturingAbout the role
Clinical Appeals Coordinator As one of the largest and most respected specialty pharmacies, BioPlus creates a meaningful difference to our patients, prescribers, payers, and pharmaceutical partners. Our 2 - Hour Patient Acceptance Guarantee gives a quick response to prescribers and patients for critical, time - sensitive treatments. As we continue to grow, we need exceptionally talented, bright, and driven people. If you would like to help us continue to be the innovative leader in our industry, this is your chance to join our team.
Job Description:
The Appeals Coordinator is responsible for gathering all information required on an appeal, writing, and submitting the appeal to insurance company and for all follow up phone calls and documentation of these appeals.
Responsibilities:
Confirm prescriber/ patients request to appeal.
Verify the information needed by the plan for an appeal and where to submit.
Gather all necessary information from prescriber office to complete the appeal.
Responsible for writing the letter of appeal.
Notifying appropriate staff of approved/denied medications.
Process/reverse online claims as required.
Responsible for maintaining required spreadsheets if applicable.
Responsible for all follow up phone calls to the insurance company orprescriber office for status of appeal or request for additional information.
Responsible for all documentation of appeal statuses into CPR+ progress notes.
Update sales staff with pertinent information.
Participate and perform other duties as assigned by leadership
Skills & Abilities: Demonstrate the BioPlus C.A.R.T. values.
Competence:
- AccountabilityRespectTrustExcellent Computer Skills.
- Knowledge of medical terminology.
- Excellent communication skills.
- Ability to work cooperatively and be a liaison between departments when needed.
- Professional Image
- QualificationsQualifications & Abilities:
- High School Diploma or Equivalent.
- At least 1 year experience working with appeals, prior authorizations, or billing.
- Specialty pharmacy experience preferred.
Additional Information:
BioPlus offers competitive compensation packages including health care, 401(k), growth potential, and a challenging and exciting work environment. BioPlus is an Equal Opportunity Employer
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JOB OVERVIEW
Experience level
Senior
Location
Altamonte Springs, FL
Occupation
Medical Secretaries and Administrative Assistants
Industry
Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds
Posted
10 days ago
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