Patient Care Coordinator - Louisville, Ky
CuraScript (Louisville, Kentucky)

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Patient Care Coordinator- Louisville, KY

Company: Curascript

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Description

ABOUT CURASCRIPT

At CuraScript, we are dedicated to the delivery of extraordinary care, one patient at a time. Providing affordable, high quality care for complex chronic conditions requires cooperation among many healthcare experts. CuraScript offers a broad range of services for physicians, health plan sponsors, and pharmaceutical manufacturers to support the delivery of that care. Committed to our core values of compassion, integrity and quality, we measure our success through healthy outcomes, satisfied clients and clarity of vision to support the hundreds of new life-changing biopharmaceutical drugs that will help patients in the decades to come.

ABOUT THE DEPARTMENT

CuraScript, a wholly owned subsidiary of Express Scripts, is a leading national provider of specialty pharmacy services. CuraScript offers a broad range of healthcare products and services for individuals with chronic health conditions, such as growth hormone deficiencies, hepatitis C, hemophilia, HIV/AIDS, oncology, multiple sclerosis, and rheumatoid arthritis. CuraScript provides comprehensive patient management services including clinical case management programs, counseling, education, outcomes measurement, social services, and reimbursement services. CuraScript Wholesale Services provides customized supply chain solutions for the biotech industry.

RESPONSIBILITIES

This position is responsible for verifying diagnosis on new and existing patient referrals; healthcare benefit coverage, obtain authorization for  either via NCPDP or major medical process to ensure payment for all services rendered.  To be successful in this position, there must be an understanding of a customer service call center environment, providing quality and ethical customer services at all times. A strong background in Micro Soft Word and managing Excel spreadsheets; the ability to prioritize; multi-task; function independently and take directions from multiple individuals and the ability problem-solve and provide improvement methodologies of existing processes are essentials that are  key factors that an employee must have to be successful in this position as well.

ESSENTIAL FUNCTIONS:
The 5 or 6 major task areas required of the incumbents to successfully perform in this job.  This list should address at least 80 percent of the job’s duties.

Receives initial referral(s), verify patient’s demographics, medical history; current diagnosis and enters into appropriate electronic system.
Receives initial physician orders, as well as, new physician orders for existing patients and routes to the appropriate case managers.  Determines whether nursing services are applicable or not. Helps prepare ABN¿s for non qualifying DX or non paying treatment.
Verifies healthcare benefits, obtains authorization and if there are problems works with the healthcare payor(s) to resolve the problem and communicates resolution to appropriate individuals.  If the claim(s) is rejected, via NCPDP, the Intake Coordinator will work through the process to resolve the issue with the claim(s) so that it can be processed for payment.
Benefits/Precertification/Primary Care Provider: Determine whether requested services require precertification and follows-up with healthcare payor(s). Prepares the prescription for running test claims for approval for PBM claims.
Maintains patient activities in patient notes, via electronic system, so that protocols for patient care are adhered to at all times.
Performs other duties as assigned.

Requirements

High school diploma or G.E.D. Required
LPN or pharmacy technician experience preferred.
Minimum one year medical experience preferably in a home healthcare or other medical setting, such as, hospital admission.
Minimum one year customer service experience required.
Minimum one year Micro Soft Word and Excel required.
Minimum one year medical terminology or medical coding preferred.

EEO STATEMENT

Express Scripts is an Equal Employment Opportunity Employer and will not discriminate against or harass any applicant or employee on any grounds prohibited under any federal, state or local law, including race, creed, color, religion, sex, national origin, age, disability, sexual orientation, marital status or membership in any other legally protected class. None of the questions in our application are intended to elicit information regarding any protected characteristics, nor imply any limitation, illegal preferences or discrimination based up non-job related information or protected characteristics

BENEFITS

Express Scripts is committed to providing a quality benefits program that responds competitively to employee needs. This translates into our 2007 Benefits Program, which represents a valuable component of total compensation. Most benefits begin on the first day of the second full month following your start date. Specific benefits are available to full-time (30+ hours/week) and part-time (24-29 hours/week) employees.

Health Plan

Dental Plan

Pharmacy Benefits

Vision Plan

Basic Life/AD&D

Supplemental Life

Flexible Spending Accounts (Health Care & Dependent Care)

Short Term Disability

Long Term Disability

Tuition Reimbursement

401(k) Plan

Employee Stock Purchase Plan

Financial Planning

Paid Time Off, bereavement, jury duty

In-house education and professional development resources

Coverage for domestic partners

Business casual dress policy

Adoption assistance

Employee Assistance Program

GlobalFit Health Club Discount Program

Please click here to apply for the position.