Pharmacy Support - Coordinator 1
QualificationsPlease click hereto apply.
Troubleshoot incoming pharmacy calls from Medicaid recipients and providers through the use of LMMIS, MMIS, LAMedicaid.
com and LaPRIMS.
Create a positive customer service experience, ensure timely resolution or escalation, communicating promptly on progress and handling callers with a consummately professional attitude.
Analyze and resolve questions and requests.
Log and track calls.
Follow up with other support staff involved in resolution to ensure requests are resolved, filled and the customer communication is complete.
Document resolutions and update self-help and staff knowledge bases.
Educate callers on LA Medicaid pharmacy benefit billing and compliance policies.
Research solutions to resolving callers' problems and clearly communicate any viable options and/or solutions.
Route and transfer non?pharmacy calls to the appropriate departments.
Track and log calls as required.
Provide assistance as needed to Pharmacy Program Pharmacists and Pharmacy Support Supervisor, including, but not limited to, performing mail?outs, data entry, provider calls, information requests and policy and programmatic research.
Conduct special data analysis projects pertaining to the pharmacy program as requested.
Conduct periodic reviews of pharmacy claims to assess adherence to Medicaid program policies and procedures.
Resolve customer and provider relations issues.
Maintain and expand general knowledge of the Pharmacy unit and an overview of LDH Medicaid operation to increase ability to resolve requests on first contact.
Perform Fiscal Intermediary duties such as processing financial recoveries from providers and processing drug manufacturer payments.
Maintain and protect confidentiality with regards to all aspects of members care, personal information and employee information.
Participate in development/review of Pharmacy Audit project.
Assist lead with any and all duties associated with on-going Pharmacy Audit projects.
Other tasks as directed.
QUALIFICATIONSREQUIRED Bachelor's degree or 6 years of professional experience in lieu of degree.
Proficient in the use of Microsoft Office, including but not limited to Outlook, Word, and Excel.
Excellent analytical skills, effective organizational and time management skills.
Great attention to detail and follow up, and verbal/written communications skills.
DESIRED Minimum 1 year of professional customer service experience.
Professional experience in health care field or Medicaid program support.
Knowledge of Medicaid Policy or Pharmacy Rebate Program.
Experience with data analysis and research.
CPT, ICD-9 and ICD-10 coding and HCPCS knowledge.
CHDA, HIM, RHIA, RHIT, CCA, CMA, CPA, CIA, CGAP, HFMA or other relevant industry certifications.
Recommended Skills Analytical Attention To Detail Auditing Billing Cpt Coding Claim Processing Estimated Salary: $20 to $28 per hour based on qualifications.
Troubleshoot incoming pharmacy calls from Medicaid recipients and providers through the use of LMMIS, MMIS, LAMedicaid.
com and LaPRIMS.
Create a positive customer service experience, ensure timely resolution or escalation, communicating promptly on progress and handling callers with a consummately professional attitude.
Analyze and resolve questions and requests.
Log and track calls.
Follow up with other support staff involved in resolution to ensure requests are resolved, filled and the customer communication is complete.
Document resolutions and update self-help and staff knowledge bases.
Educate callers on LA Medicaid pharmacy benefit billing and compliance policies.
Research solutions to resolving callers' problems and clearly communicate any viable options and/or solutions.
Route and transfer non?pharmacy calls to the appropriate departments.
Track and log calls as required.
Provide assistance as needed to Pharmacy Program Pharmacists and Pharmacy Support Supervisor, including, but not limited to, performing mail?outs, data entry, provider calls, information requests and policy and programmatic research.
Conduct special data analysis projects pertaining to the pharmacy program as requested.
Conduct periodic reviews of pharmacy claims to assess adherence to Medicaid program policies and procedures.
Resolve customer and provider relations issues.
Maintain and expand general knowledge of the Pharmacy unit and an overview of LDH Medicaid operation to increase ability to resolve requests on first contact.
Perform Fiscal Intermediary duties such as processing financial recoveries from providers and processing drug manufacturer payments.
Maintain and protect confidentiality with regards to all aspects of members care, personal information and employee information.
Participate in development/review of Pharmacy Audit project.
Assist lead with any and all duties associated with on-going Pharmacy Audit projects.
Other tasks as directed.
QUALIFICATIONSREQUIRED Bachelor's degree or 6 years of professional experience in lieu of degree.
Proficient in the use of Microsoft Office, including but not limited to Outlook, Word, and Excel.
Excellent analytical skills, effective organizational and time management skills.
Great attention to detail and follow up, and verbal/written communications skills.
DESIRED Minimum 1 year of professional customer service experience.
Professional experience in health care field or Medicaid program support.
Knowledge of Medicaid Policy or Pharmacy Rebate Program.
Experience with data analysis and research.
CPT, ICD-9 and ICD-10 coding and HCPCS knowledge.
CHDA, HIM, RHIA, RHIT, CCA, CMA, CPA, CIA, CGAP, HFMA or other relevant industry certifications.
Recommended Skills Analytical Attention To Detail Auditing Billing Cpt Coding Claim Processing Estimated Salary: $20 to $28 per hour based on qualifications.
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