Specialty Pharmacy Financial Counselor
Why Join the Specialty Pharmacy Team?
Our services are unrivaled compared to your neighborhood retail and mail-order pharmacies. We continue to grow as new specialty drugs become available, increasing the number of patients we are privileged to serve and volume of prescriptions we manage. These medications are generally high-cost and patients can face obstacles in acquiring these medications. That's where our Financial Counselors are there to help. As a Financial Counselor, you will serve as a valuable member to our patients in facilitating their enrollment process and assist those already enrolled. In this dynamic position, you will navigate the complexities of insurance benefits and research any other additional resources that may be available. You'll build strong rapport with patients by continuously monitoring their insurance for changes in benefits and coverage, update billing information as needed, and maintain consistent communication with the patient. We are a highly ambitious team who share the common goal of ensuring our patients have the right medications at the right time at the lowest cost possible. Do you love working one on one and counseling patients on their insurance benefits in order to increase access and to minimize patient out-of-pocket expenses? If so, we encourage you to apply today.
What perks and benefits can you look forward to:
- Excellent medical, dental, and vision coverage
- 2:1 match on retirement savings
- Generous PTO program
- Tuition Reimbursement Program
- Tremendous team support
For more information about the UMHS Department of Pharmacy Services, see our annual report at: https://www.medicine.umich.edu/dept/pharmacy/pharmacy-annual-report
You will obtain detailed insurance benefit information to successfully adjudicate a specialty medication claim.
You'll evaluate patients’ medication, insurance, and financial situation and counsel them regarding their prescription insurance coverage, benefits, and related requirements.
You'll assist patients with the necessary documentation needed to apply for extra help, charity care, manufacturer drug assistance, Medicaid, and/or other qualifying insurance or assistance programs.
You'll review work queues in our electronic health record MiChart for billing questions, errors or high balances. Troubleshoot complex billing issues (insurance/prior authorization, coordination of benefits, etc) and resolve them.
You will communicate complex insurance and financial information associated with specialty medications to all areas within the medical center including clinics and providers as well as insurance companies, patients, and their families.
You will facilitate patient enrollment or transition to a non-UMHS pharmacy when needed based on patients’ preference or insurance requirements to ensure uninterrupted access to their specialty medication.
You will stay up to date on current regulations and requirements of insurance companies, assistance programs and other medication resources
You will identify, develop and implement additional projects and process improvements including Lean projects in collaboration with the PFC team, Specialty Pharmacy and any other team involved.
You will update and maintain policies and procedures including training materials and check lists.
Minimum one year experience in a pharmacy or medical office setting with background in insurance benefits, billing and verification, and patient financial counseling.
Excellent written and verbal communication skills.
Excellent customer service skills.
Bachelor or associate degree in a healthcare-related field or 3-5 years experience in a pharmacy or medical office setting.
Ability to work well in a team as well as independently with minimal supervision, consistently problem solving and managing time in an efficient and productive manner.
Knowledge of medical and prescription insurance company policies and requirements (i.e. Medicare, Social Security, Medicaid, and Medicare Part D).
Ability to handle time-sensitive information while maintaining strict patient confidentiality
Analytical and computing skills with Word and Excel programs.
Experience with OTIS, Thera-Doc MiChart, NRX, Webdenis, and other billing and verification programs.
This position is primarily located at 300 North Ingalls and rotates through the Taubman Center.
Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act.
Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
Job openings are posted for a minimum of seven calendar days. This job may be removed from posting boards and filled anytime after the minimum posting period has ended.
U-M EEO/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.