Serves as a liaison between the physician, patient, case worker, business service coordinator and the pharmaceutical manufacturers regarding the reimbursement, replacement, or provision of free medications to patients utilizing medication assistance programs for the uninsured, under-insured, indigent and for those who have exceeded their maximum level of insurance coverage. Monitors high cost medications for appropriate reimbursement with the assistance of the Coordinator, Pharmacy Reimbursement + Corporate Compliance. Communicates to the appropriate ambulatory and inpatient personnel billing codes for new medications as they are added to the Geisinger formulary. Serves as a resource regarding eligibility criteria, enrollment requirements and contacts for all pharmaceutical manufacturer's medication assistance programs.
Works under the direct supervision of the Director, Pharmacy Reimbursement and Corporate Compliance.
COMPETENCIES AND SKILLS:
Demonstrates ability to learn various GHS billing systems.
Demonstrates excellent mathematical skills (percentages, ratios, etc.), clerical skills, and the ability to communicate effectively.
Demonstrates ability to develop and implement programs.
Demonstrates working knowledge of Microsoft Excel, Word and database.
Demonstrates knowledge of medical terminology and medication names. Knowledge of third party billing preferred and ICD-9 and MCPT coding helpful.
EDUCATION AND/OR EXPERIENCE:
Associates Degree with 1-2 years professional experience utilizing computer skills including spreadsheet and database required.
Minimum of 3-5 years experience may be substituted for an Associates Degree.
Minimum of 2 years interacting with patients and healthcare providers.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Work is typically performed in an office environment.
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
GEISINGER WYOMING VALLEY MEDICAL CENTER: (GWV), located in Wilkes-Barre, Pa., is an acute care hospital that is licensed for 274 beds, and houses the only Level II Trauma center in Luzerne County. The campus includes the Frank M. and Dorothea Henry Cancer Center, The Richard and Marion Pearsall Heart Hospital, the Janet Weis Children’s Hospital Pediatric Unit, a transplant program and the Brain & Spine Tumor Institute. Geisinger South Wilkes-Barre is GWV’s ambulatory campus.
One of the nation’s most innovative health services organizations, Geisinger serves more than 1.5 million patients in Pennsylvania and New Jersey. The system includes 13 hospital campuses, a nearly 600,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. A physician-led organization, with approximately 32,000 employees and more than 1,800 employed physicians, Geisinger leverages an estimated $12.7 billion positive annual impact on the Pennsylvania and New Jersey economies. Repeatedly recognized nationally for integration, quality and service, Geisinger has a long-standing commitment to patient care, medical education, research and community service. For more information, visit geisinger.org or connect with us onFacebook, Instagram, LinkedInand Twitter.
** Does not qualify for J-1 waiver. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
*Domestic partner benefits not applicable at Geisinger Holy Spirit.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencing
programs, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.
Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.