Patient Benefits Supervisor

Onco360•Woodridge, IL

About The Position

Onco360 Pharmacy is a unique oncology pharmacy model created to serve the needs of community, oncology and hematology physicians, patients, payers, and manufacturers. Our Onco360 Pharmacy in Woodridge, IL has an immediate need for a Patient Benefits Supervisor. The shift and hours for this position are Monday-Friday 9:30am-6pm EST and some weekends as needed. The Patient Benefits Supervisor will be responsible for oversight of activities relating to the proper loading and investigation of patient prescription benefits, including but not limited to patient demographics, medical and pharmacy coverage, and investigation/identification of authorization requirements needed to obtain medications. This role requires advanced program knowledge and will provide quality control by routinely examining cases completed by team members.

Requirements

High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification
4+ years pharmacy or benefit verification experience, previous leadership experience
Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, excellent interpersonal skills, able to work with all levels of management and staff, vast knowledge of pharmacy terminology and process including sig codes, and roman numerals, brand/generic names of medication, advanced typing, math and analytical skills, leadership skills
Registration with Board of Pharmacy as required by state law
Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skills, leadership

Nice To Haves

Associates or Bachelor’s Degree, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience
5+ years pharmacy or benefit verification experience, 1+ years supervisor experience, Specialty pharmacy experience
Specialty pharmacy operations, independent decision-making abilities, able to conduct research, be resourceful, and self-reliant, excellent communication skills
Certified Pharmacy Technician (PTCB), Advanced Certified Pharmacy Technician with completion of Billing and Reimbursement certification

Responsibilities

Supervises BV/onboarding staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee relations issues and reduce turnover. Communicates effectively across pharmacy and/or corporate teams and with patients, and successfully resolves issues.
Assists manager in day-to-day pharmacy operations and in implementing new procedures to ensure that the accurate and timely dispensing of quality pharmacy services is consistently delivered to all patients using effective service leadership and customer skills.
Works with pharmacy management to recruit, select, hire, orientate, develop, and train new associates. On an ongoing basis, evaluates, coaches, and utilizes performance management practices to motivate and set expectations for BV staff. In collaboration with management, drafts and delivers effective corrective action plans and disciplinary action to technicians performing at substandard levels.
Manages and reports on daily activity of vertical team members, including monitoring of daily workflow and Pulse reporting.
Manage patient authorizations specific to Threshold Override Authorizations (TOA), SNF Letters of Agreement (LOA), and the like.
Monitors and escalates No-Go trends or contract-related claim rejections to Patient Benefits Manager
Provides ongoing access and training on web tools to the BV/Onboarding team and offers frontline support to address system functionality questions and issues (Ex: provider eligibility portals, copay card portals, applications, etc.)
Communicate to Pharmacy personnel payor benefit programs and policies and ensure all payer types are handled correctly by the team.
Handles escalations for difficult BV cases/questions to ensure accurate and timely completion of BV
Works with Pharmacy Technician Manager and/or Director of Pharmacy Operations on other responsibilities, projects, implementations, and initiatives as needed.
Maintains a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws.
Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.
Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.