Centene Corporation Reimbursement Specialist I, Foundation Care in Earth City, Missouri
HourlyPosition Purpose: Responsible for insurance verification, needed authorizations and billing of all third party payers and patients by performing the following duties. Works across the organization to ensure patient, caregiver, and customer needs are met.
Ensures claims are processed in a timely manner
Communicates with Pharmacy Benefit Managers and third party payers as needed
Follows up with denials and assists with appeals as indicated
Processes secondary insurance claims and patient invoices
Completes benefits investigations, prior authorizations, and other reimbursement related tasks as applicable
Processes copay assistance, patient assistance, first fill assistance, and manufacturer specific program assistance as necessary
Ensures third party payer data base is accurate
Assists with order fulfillment as assigned
Maintenance and upkeep of appropriate documentation required by federal and state agencies
Assists in development of systems to maintain and improve reimbursement
Observes and complies with all policies and procedures
Completes mandatory training requirements
Supports quality initiatives as assigned
Performs other duties as assigned
Education/Experience: High school diploma or General Education Degree (GED); six months to one year related experience preferred; or equivalent combination of post high school education and experience.
License/Certification: Missouri pharmacy technician registration, to be obtained within 90 days of hire
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
TITLE: Reimbursement Specialist I, Foundation Care
LOCATION: Earth City, Missouri
COMPANY: Health Insurance Operations
POSITION TYPE: Hourly