Specialty Pharmacy Account Coordinator (Non-Exempt)

Job Title: Specialty Pharmacy Account Coordinator I
Location: Mercy Specialty Pharmacy - Riverport I
Schedule: Full-time | Monday-Friday | 8:00 AM - 5:00 PM

Overview:
The Specialty Pharmacy Account Coordinator I plays a critical role in supporting patients through complex medication therapies by coordinating insurance, financial assistance, and pharmacy services. This position works under the direct supervision of a pharmacist and in compliance with all federal and state regulations.

Key Responsibilities:

• Patient Account Coordination:

  • Process patient accounts efficiently and accurately in assigned sections.
  • Verify insurance eligibility, benefits, and pre-certification requirements, including for infused medications.
  • Ensure compliance with medical necessity criteria and payer policies (e.g., FDA, NCCN).
  • Manage denials, identify root causes, and recommend process improvements.

• Financial Assistance & Program Management:

  • Identify and enroll patients in applicable assistance programs (e.g., copay cards, foundations, PAPs).
  • Collect and submit required documentation on behalf of patients.
  • Track application status and ensure timely follow-up.
  • Register patients for drug replacement programs and appeal insurance denials when necessary.

• Pharmacy Operations Support:

  • Function as a Senior Pharmacy Technician as needed.
  • Prepare and fill medication orders under pharmacist supervision.
  • Maintain and secure drug inventory; deliver medications post-verification.
  • Retrieve and credit unused medications appropriately.

• Leadership & Quality Assurance:

  • Monitor workflow and conduct quality audits.
  • Assist in training and development of coworkers.
  • Lead task forces and contribute to new program implementation.
  • Recommend and help implement procedural improvements.

• Communication & Collaboration:

  • Serve as a resource for staff and patients.
  • Communicate effectively with physicians, insurance companies, and internal teams.
  • Address complex patient concerns and model professional behavior.

• Compliance & Development:

  • Stay current on insurance regulations and billing guidelines.
  • Complete all mandatory training and pharmacy competencies.
  • Participate in quality assurance and medication use evaluation programs.

Qualifications:

• High school diploma or equivalent required; associate degree or higher preferred.
• Experience in pharmacy operations, insurance verification, or healthcare billing strongly preferred.
• Strong knowledge of specialty pharmacy, oncology billing, and patient assistance programs.
• Excellent communication, organizational, and problem-solving skills.
• Proficiency in pharmacy systems and Microsoft Office Suite.

From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.

Join a caring, collaborative team where your voice matters. At Mercy, you'll help shape the future of healthcare through innovation, technology, and compassion. As we grow, you'll grow with us.