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Hub Reimbursement Specialist & Patient Care Coordinator

RIS Rx
Newport, CA Full Time
POSTED ON 3/3/2025
AVAILABLE BEFORE 6/2/2025

Job Title : Hub Reimbursement Specialist & Patient Care Coordinator

Reports to : Program Manager

FLSA Status : Non-exempt

Duties and Responsibilities include but are not limited to the following :

  • Triage all incoming phone calls, faxes, and referrals
  • Call insurance plans to follow-up on submitted prior authorizations, when applicable
  • Communicate to the staff and then escalate to the Program Manager for any unresolved issues
  • Proactively monitor program for possible issues before prescription abandonment
  • Follow all applicable government regulations including HIPAA

Qualifications :

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Skills :

  • Knowledge of pharmacy claims adjudication process
  • Accurate data entry
  • High level of customer service and empathy
  • Experience with PC and Microsoft Word and Excel required
  • Strong third-party managed care knowledge
  • Excellent written and oral communication skills along with problem solving skills required
  • Ability to problem solve under pressure
  • Attention to Detail
  • Organization and Time Management Skills
  • Decision Making and Judgment
  • Accountability and Dependability
  • Ethics and Integrity
  • Relationship Building
  • Education / Experience :

  • Valid and current national pharmacy technician licensed issued by the Pharmacy Technician Certification Board (PTCB) preferred
  • 2 years of experience in a prior pharmacy hub setting preferred
  • Computer Skills :

    To perform this job successfully, an individual should have working knowledge of :

  • Microsoft Office (Excel, Word, PowerPoint, etc.)
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    Job openings at RIS Rx

    RIS Rx
    Hired Organization Address Newport, CA Full Time
    Job type Full-time Shift and schedule 8-hour shift Monday to Friday Full job description Background: At RIS Rx, we belie...

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