Pharmacy Benefits Case Manager

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Adecco is currently assisting a client in their search to fill a Case Manager role in Lewisville, TX!

 

Apply now if you are interested and meet the qualifications listed below!

 

POSITION: Pharmacy Benefits Case Manager

LOCATION: Lewisville, TX

PAY: $18 /hr

DURATION: 3 Months

HOURS: 11am – 8pm

 

Description of Work:

  • Monitor system accounts for new Patient cases
  • Conduct outbound calls to patients to confirm approval/denials of coverage, co-pays and verification of specialty pharmacy that will dispensing their medication
  • Contact insurance companies as required to obtain and enter accurate benefit information to positively impact insurance processing and minimize rejections
  • Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to deescalate
  • Place outbound calls to patients to assess for eligibility for co-pay and financial assistance
  • Answer minimal inbound calls from doctors and/or patients checking on status of case
  • Maintain quality while providing an empathetic and supportive experience to the patients, providers, and physician offices
  • Resolve patient's questions and concerns regarding status of their request for assistance
  • Enter detailed information into company proprietary software while conversing via telephone
  • Steward patient accounts from initial contact through final approval/denial
  • Process all patient applications in accordance to set policy, procedures and PHI compliance
  • Speak with manufacturer field team members on case updates via phone or by email
  • Works internally with team members regarding patients’ cases
  • Ability to identify, document and submit Adverse Events during customer contact or via received documentation
  • Conduct research associated with alternative funding or foundations to ensure patient has required information to receive product

 

Skills/Qualifications:

  • Previous healthcare experience with insurance or in pharmaceutical industry, preferred
  • Pharmacy benefits management experience preferred with specific knowledge of Medicare, Medicaid and commercially insured payer common practices and policies, preferred
  • Previous prior authorization and appeals experience highly desired
  • Knowledge of ICD coding preferred
  • Intermediate Microsoft skills with specific experience with Excel
  • Organized with the ability to prioritize multiple, concurrent assignments and work with a sense of urgency
  • Exceptional communication skills both verbally and written
  • Self-starter with demonstrated initiative, creativity and a willingness to learn

 

Education:

Minimum of HS diploma; additional education preferred

 

How to Apply: Click on “Apply Now” to be considered for this position or any other opportunities with Adecco.

 

***Applicants must be currently authorized to work in the United States on a full-time basis. We’re unable sponsor applicants with the following work visas: H1B, H2B, E3, TN1***

 

How to Apply: Click on “Apply Now” to be considered for this position or any other opportunities with Adecco.

 

Once candidates have applied, resumes will be screened for review. I will reach out to you if are chosen for the next step in the application process. If you have any questions, please feel free to reach out to:

Recruiter: Darrin Rice

Email: Darrin.rice@adeccona.com

 

IMPORTANT: This position is being recruited for by Adecco’s National Recruitment Center, not your local Adecco Branch Office. To be considered for this position, you must use the “apply now” button to submit your resume for review. For other opportunities available at Adecco go to www.adeccousa.com.

 

The Adecco Group is a global leader in HR services. Our group connects over 700,000 associates with our business clients each day through our 6,600 offices in over 70 countries and territories around the world. We offer employment opportunities at any stage in your professional career. Contact us today to discuss available contract and direct hire positions. Adecco Group provides one of the most comprehensive benefits packages in the industry to contract workers to include Holiday, 401(k), Insurance Benefit Plans and Service/Anniversary Bonus opportunities.

 

Equal Opportunity Employer Minorities/Women/Veterans/Disabled

  • Apply with Adecco

Reference number US_EN_99_022862_438100