Clinical Care Coordinator

Meijer Inc. | Grand Rapids, MI

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Posted Date 11/23/2022
Description We opened our doors more than 85 years ago with the goal of helping people provide for themselves and their family. Today we’re a multi-billion dollar retailer with more than 70,000 employees across six states. Our Midwest geography includes corporate offices in Grand Rapids, Michigan, plus manufacturing facilities, distribution centers and over 240 stores across Michigan, Illinois, Indiana, Kentucky, Ohio and Wisconsin. Meijer is an Equal Opportunity Employer, fostering a diverse and inclusive workplace. We are committed to treating all persons with dignity and respect. Meijer's policy is to not discriminate because of any applicant or team member's race, color, national origin, sex, sexual orientation, gender identity or expression, pregnancy, religion, age, physical or mental disability, uniformed service or veteran status, or any other lawfully-protected classification. If you need a reasonable accommodation of a disability to complete any part of your application, please click here to submit your request. As a family company, we serve people and communities. When you work at Meijer, you’re provided with career and community opportunities centered around leadership, personal growth and development. Consider joining our family – take care of your career and your community! Meijer Rewards Weekly pay Scheduling flexibility Paid parental leave Paid education assistance Care.com/back-up care assistance Team member discount Development programs for advancement and career growth Please review the job profile below and apply today! The Clinical Care Coordinator acts as a liaison and coordinates communications between the physician offices, patients and payersfor prior authorization and appeal support. This person must be an expert in all stages of filling specialty medication prescriptions. The Clinical Care Coordinator works to ensure all specialty service expectations are met or exceeded through process improvement, coordinating operational updates and training. . What You'll Be Doing: Encompasses all skills required of the Patient Service Coordinator role. Responsible for completing benefits investigation to determine patients’ medication insurance coverage. Supports the insurance authorization and appeals processes consistent with prescriber and third party payers requirements. Reviews patient clinical documents for relevant clinical and demographic information as required by the payer. Maintains complete and accurate documentation of all patient care activities performed. Responsible for retaining working knowledge of insurance companies formularies’ and therapy approval requirements. Communicates regularly with patients and providers about the prior authorization process. Serves as primary point-of-contact for insurance companies and provider offices for insurance verification. Ability to work across multiple disease states. Maintains confidentiality of patient information. Communicates effectively with internal departments supporting specialty pharmacy including Sales, Managed Care, Procurement, Operations and Trade Relations. Supports dispensing locations with the process for filling specialty prescriptions. Provides prompt and accurate information to external and internal customers to ensure client satisfaction. This job profile is not meant to be all inclusive of the responsibilities of this position; may perform other duties as assigned or required. What You Bring With You (Qualifications): High School Diploma or GED Equivalent required. 3+ years customer service experience required. 1 year pharmacy and/or specialty pharmacy, medical, or insurance experience preferred. 180 days as a Patient Service Coordinator highly preferred. Excellent organization skills with the ability to prioritize workload. Effective written (including legible penmanship) and verbal communication skills and agent of change. Ability learn new technologies and systems Excellent customer service skills Proficient keyboard skills. Teamwork. Demonstrated commitment to consistent attendance. Basic Math Skills. Excellent telephone skills.
Job Type
Full time

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