Co-Pay Recovery Associate I:
PharMerica

34569-en_US
PharMerica
Louisville Colorado
Pharmacy
Apply
Description

PharMerica Corporation is a premier institutional pharmacy services provider, dedicated to providing quality patient care and innovative pharmacy solutions to institutional customers and patients in long-term care settings. With nearly $2 billion in annual revenues, PharMerica is one of the nation's largest institutional pharmacy companies. PharMerica operates more than 100 institutional pharmacies in 45 states and serves nursing facilities that care for approximately 350,000 patients.

 

 

Essential Functions:

 

  • Works to ensure compliance with CMS reimbursement policies concerning Low Income Subsidy (LIS) guidelines and establishing Best Available Evidence (BAE).
  • Recognize situational profiles that deem specific residents ineligible for LIS and/or individual claims that are not covered by the CMS statutes.
  • Creates “BAE” packets for submission to insurance plans and follow up as needed to ensure proper delivery and action as directed by CMS for the insurance plan to review evidence and update status   when deemed appropriate.
  • Follow up with insurance plans to verify payments have been made after any or all adjustments to LICS Level have been performed.
  • Work to resolve accounts requiring special attention, through written processes in order to resolve which may include intradepartmental communication.
  • Work with Cash Processing, Third Party Recon, and billing departments to evaluate cash available to relieve outstanding copays, thus minimizing write-offs due to untimely cash transfers.

 


Minimum Qualifications:
•High School graduate, GED or equivalent experience
•Data entry, MS Excel and Outlook and basic computer knowledge, and comfort level moving through multiple platforms on dual screen setup.
•Dependability, Communications, Detail Orientation, Problem Solving and Enthusiasm

 

EOE M/F/D/V

Accelerate Your Career with PharMerica!

Basic Qualifications
Requirement