What are the responsibilities and job description for the Clinical Resource Assistant position at Fundamental Administrative Services, LLC?
Position Summary
Responsible for working under the direction of the Director of Pharmacy Services to support client facilities as well as work with health care providers, pharmacy staff, and insurance companies to facilitate continuity of care.
Posted Salary Range
USD $20.00 - USD $25.00 /Hr.Duties & Responsibilities
Essential Functions and Responsibilities:
Timely and routine reporting of non-covered claims to FCOS Director of Clinical Pharmacy Services.
Review chain/facility non-covered issues via pharmacy portals.
Submit and track prior authorization requests for long-term care orders.
Review patient eligibility information to ensure appropriate documentation is submitted.
Work with pharmacy personnel when necessary to facilitate processing of PAs and covered alternatives.
Refine (where necessary) the PA submission process between pharmacies and insurance companies.
Collaborate with facility staff, physicians, and care teams to obtain required medical records and supporting documents.
Follow up on pending authorizations, resolve issues, and escalate delayed approvals to avoid service disruptions.
Communicate authorization status updates to facility staff and pharmacy team.
Maintain accurate records of authorization requests, approvals, and denials for auditing and reporting purposes.
Work with billing and reimbursement teams to minimize claim denials related to authorization issues.
Qualifications & Requirements
Associate degree or certification in Medical Assistant, Healthcare Administration, or a related field preferred.
Previous experience in healthcare administration, medical office, or customer service (1-2 years preferred)
Experience with insurance verification or medical billing is a plus
Must have a reliable source of transportation. May be required to travel by air a couple times a year.
Benefits
All of our employees are valued and receive a competitive wage; full time team members are also offered a comprehensive benefit package which includes:
- Medical, Dental, Vision, Life and Disability Insurance
- Flexible Spending Accounts
- Tuition Reimbursement & Loan Repayment Programs
- PerkSpot - Local Deals and Weekly Perks Program
- 401(k)
- Vacation/Holiday/Sick Pay Plan
- Pet Insurance Discount
- DailyPay option available! Get your pay, when you need it
- Purchasing Power - online purchase/payroll deduction
- Tickets at Work - entertainment ticket discounts
- Employee Assistance Plan - easy-to-use services to help with everyday challenges of life (available for all employees and their families)
- Helping Friends Foundation - our employees hardship/crisis fund
- Auto and Home Insurance - employee discount available & payroll deduction
EOE Statement
Drug Free, Smoke-Free work place. Equal Opportunity Employer, including disability/vets
Salary : $20 - $25
