Enhanced Benefits Coordinator Augusta
Wellstar Health System
Summary
The Enhanced Benefits Coordinator serves as the hub for prior authorizations associated with key service lines within the medical center as well as health system clinics. This position will obtain and validate insurance and financial information, obtain any required precertification and/or prior authorization for in office administered medications, and provide benefits overviews to patient prior to treatment. This position is responsible for providing front line, direct contact with patients, families, providers, nurses, social workers and pharmacies.
Job description
Job Summary
The Enhanced Benefits Coordinator serves as the hub for prior authorizations associated with key service lines within the medical center as well as health system clinics. This position will obtain and validate insurance and financial information, obtain any required precertification and/or prior authorization for in office administered medications, and provide benefits overviews to patient prior to treatment. This position is responsible for providing front line, direct contact with patients, families, providers, nurses, social workers and pharmacies.
Core Responsibilities and Essential Functions
- Screens, processes, and completes prior authorization through medical benefits and pharmacy benefits.
- Follows-up with patients, providers, and insurance plans on refills and reauthorizations, as required by payers.
- Processes infusion/injection appointments through WMCG IT platforms in an accurate manner.
- Coordinates with Medication Assistance Coordinators for specialty medications filled through pharmacy benefits or medications accessed through assistance programs. Coordinates shipping activities associated with patients own medication to ensure accurate and timely medication delivery.
- Collaborates with other members of the Pharmacy Department team for performance improvement, customer service excellence, and quality assurance (teamwork).
- Performs other duties as assigned
- Complies with all Wellstar Health System policies, standards of work, and code of conduct.
Required Minimum Education
High School Diploma / GED General or Bachelors General-Preferred
Required Minimum License(s) and Certification(s)
All certifications are required upon hire unless otherwise stated. PHT - Registered Pharmacy Tech
Required Minimum Experience
Minimum 1 year Pharmacy Technician role or in enhanced benefits or similar role in medical office/center, Pharmacy required. Minimum 2 years Pharmacy Technician role or in enhanced benefits or similar role in medical office/center, Pharmacy preferred.
Required Minimum Skills
communication skills, organizational skills, prioritization, time management. Microsoft Office proficiency. Proficient with medical terminology. Experience with prior authorizations, insurance, claim adjudication and claim appeals.- Preferred
Requirements
- High School Diploma / GED
- PHT - Registered Pharmacy Tech certification
- Minimum 1 year Pharmacy Technician role or similar experience
- Communication skills
- Organizational skills
- Prioritization
- Time management
- Microsoft Office proficiency
- Proficient with medical terminology
Company overview
Wellstar Health System is one of Georgia's largest and most comprehensive integrated healthcare systems, founded in 1993 and headquartered in Marietta, Georgia. As a non-profit health system, Wellstar operates with a mission to enhance the health and well-being of every person it serves through its PeopleCare approach. The system employs approximately 29,469 to 33,000 team members across multiple hospitals, health parks, medical offices, outpatient centers, pediatric centers, nursing facilities, and hospice and home care services. Wellstar is nationally recognized for operating Georgia's largest integrated trauma network and features the second-largest Emergency Department in the United States. The organization provides more than $1 billion annually in charity care and community programs, demonstrating its commitment to community health. Wellstar has earned numerous accolades including recognition on Fortune's 100 Best Companies to Work For, Best Workplaces in Health Care, and PEOPLE Companies that Care lists. The system embraces innovation through its venture firm Catalyst by Wellstar, which nurtures early-stage healthcare companies, and maintains academic partnerships with institutions like the Medical College of Georgia for caregiver training. With specialties spanning cardiovascular care, oncology, women's health, pediatrics, musculoskeletal services, and numerous other medical disciplines, Wellstar delivers comprehensive healthcare across all stages of life.