Work in Arizona Jobs

Job Information

Banner Health Pharmacy Services Representative in Gilbert, Arizona

Primary City/State:

Gilbert, Arizona

Department Name:

Admin-HIT

Work Shift:

Weekend

Job Category:

Pharmacy

A position in a Banner Health pharmacy is one you can look forward to. Join an engaging environment of full service, high technology and experience a wide variety of responsibilities. You’ll also see how important a pharmacy job is to our ability to make life easier for our patients. Come enjoy great challenges and build both your knowledge of the field and your analytical skills.

You will be working in home Infusion Pharmacy intake department with a close knit group of pharmacy and intake staff. The candidate will need to be well versed in Infusion Services, Payers, and have outstanding computer skills and problem solving abilities. Excellent customer service is a must and the team dedication to this is proven in the results of our customer satisfaction scores.

If you are an outgoing, self-motivated, and organized person who enjoys working with both internal and external customers, then come join our team. This position is a Saturday and Sunday 830am-5pm shift. You will work closely with pharmacist and pharmacy technicians to provide the highest quality customer service available in the community with personalized attention delivered with respect, compassion and professionalism.

Ranked in the top 25 percent of all home care agencies in the United States, Banner Home Care is the largest nonprofit, free-standing home care agency in Arizona. We provide intermittent health care for patients of all ages in the comfort of their home. Our home care team is experienced, compassionate and professional, and the results prove that Banner Home Care measures better than the national and Arizona average in almost all Medicare Quality Compare patient satisfaction results. Banner Hospice have been providing comfort care for the past 10 years in the Phoenix Metro area. The goal is to support quality of life, honor the wishes of patients, maintain the dignity of the individual and support the family through their grieving process. Inpatient Home care is also available for respite care and symptom management. The Banner Hospice Team can provide comfort to the patient and family by alleviating symptoms, by providing meaningful help and by creating an environment to develop lasting final memories.

POSITION SUMMARY

This position is responsible for coordinating delivery of drugs and supplies to the patient, assisting in the coordination of home infusion nursing visits, enrolling new patients, handling incoming calls from patients, health care providers and insurance companies; assuring billing accuracy, obtaining insurance eligibility and authorization, and entering patient demographics and medical history into a computerized home infusion software. Responsible for collecting and maintaining data used for verification, authorization and provision of home infusion services. Serves as a liaison between local patient care services, co-workers, equipment providers, physician’s clinics, hospitals, third party payors, patients and their family members, regulatory and other community agencies to support appropriate patient care. Also assists in maintaining patient pharmacy records, documentation, and handling of equipment. Reviews account information to optimize collection efforts and system recording events to expedite reimbursement and compliance. Explains and obtains signatures on legal forms and registration materials.

CORE FUNCTIONS

  1. Handles incoming requests for patient referrals and/or requests for services, verifies requests and provides on- going follow-up of requests up to and following patient discharge. Receives supply orders and inquiries from patients and nursing staff. Works with patients, nursing and HME warehouse to generate patient delivery tickets. Ensures adequate levels of supplies are available and arranges the delivery of supplies. Communicates with patients to arrange pickup of unused supplies and rental equipment at the end of therapy. Communicates pricing information to the patient. 1a. Builds referrals using information in patient record to provide minimum data necessary to coordinate patent services. 1b. Provides verbal and written instructions to patients, families, and coordinating resources regarding provision of products and services, reimbursement and patient financial responsibility. 1c. Performs data entry of patient intake information into computer system, requests for service, pertinent medical history, delivery information, records insurance information and authorization requirements, and supply information in the computerized software system. 1d. Coordinates requested services and referrals with service and equipment providers, pharmacy warehouse, clinical staff and sets delivery expectations between patients and providers. 1e. Facilitates problem solving with patients, hospitals, providers, referral sources, insurance companies and clinical staff. Assists in the maintenance and communication of changing payor and referral source information specific to coordination of patient needs.

  2. Verifies that all billable services and supplies have physician’s order when needed. Researches billing/activity errors and works with departments to resolve issues and make necessary adjustments. Tracks and obtains authorizations for services, enters them into the system, generates reports to identify expiring authorizations and certifications and communicates to appropriate clinical staff.

  3. Participates in audits of clinical records for billing compliance, completeness and accuracy. Communicates with appropriate staff to correct billing documents and assists in resolving documentation problems.

  4. Performs reimbursement functions including insurance eligibility, benefit verification, obtaining authorization, re-authorization and re-certification for initial and ongoing services in conjunction with Patient Financial Services. Accurately records data into appropriate software system for communication of insurance information and authorization requirements to ensure accurate and timely billing. Calculates patient liability according to verification of insurance benefits, collects deposits and co-payments. Acts as a liaison between the patient, the billing department and the payor to enhance account receivables performance, resolve outstanding issues and/or patient concerns and to maximize service excellence.

  5. Cross-trains, assists and fills in for other team members as necessary to ready pharmaceuticals for delivery. Assists in orientation development of other staff members and in quality improvement activities. Identifies opportunities to improve work processes and practices good work group dynamics.

  6. Creates and maintains daily prescription logs and prescription files and works with the pharmacists and supervisor to keep in compliance with Arizona State Pharmacy. Ensures each admission meets specified criteria. Works to ensure compliance with State, Federal and OSHA and other regulatory standards. Follows all agency and department policy and procedures.

  7. This position reports to the Director of Pharmacy. The incumbent will have contact with insurance companies, patients and their families, physicians’ offices, and other referral sources. Incumbent has daily contact with nursing, pharmacy and warehouse staff as well as communication with ancillary departments within Banner Home Care. Works independently under regular supervision and follows structured work routines. Works in a fast paced, multi task environment with high volume and immediacy needs requiring independent decision making and sound judgment to prioritize work and ensure appropriateness and timeliness of each patient’s care. This position requires the ability to retain large amounts of changing payor information/knowledge crucial to attaining reimbursement for services provided.

MINIMUM QUALIFICATIONS

The position requires knowledge normally acquired with completion of a High School Diploma or equivalent.

This position requires skills and abilities typically attained with two years of experience in medical insurance verification and data entry as well as experience in a healthcare setting in a financial services capacity. Must have a working knowledge of medical terminology and be willing to develop basic working knowledge of types of infusion devices and IV/IM/subcutaneous administration supplies, and access/delivery devices. Mathematical aptitude and arithmetic skills in order to correctly calculate doses and quantities of pharmaceuticals for pricing purposes is a must. This position requires excellent written and verbal communication, organizational and interpersonal skills along with time management aptitude. The individual must portray a friendly, helpful demeanor while assisting patients in obtaining necessary services, equipment and supplies as well as when collecting co-payments. An understanding of the components of medical records and regulations regarding the creation and maintenance of medical records as well as the ability to create spreadsheets to analyze and present data is of upmost importance.

PREFERRED QUALIFICATIONS

Previous cash collections experience.

Additional related education and/or experience preferred.

Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability.

DirectEmployers