Pharmacy Admissions Clerk

Title: Pharmacy Admissions Clerk

Dept: Billing and Reimbursement

Reports To: Admissions & Intake Manager

Position salary: $18-22/hour

Shift: 2nd shift - 4PM to 12:30AM EST

Location: Remote

Position Summary

The primary goal of the Clarest Admission Clerk is to manage and coordinate facility admissions information from our pharmacy customers in the Long-Term Care, Assisted Living or Institutional setting. Each clerk is responsible for the accuracy of insurance payer information and demographics specific to each patient or resident. This function is directly interfaced with the pharmacy workflow for fulfillment and distribution of medications and as a result, timeliness and accuracy are paramount.

Essential Functions – primary position responsibilities:

• Collect accurate patient information, including demographics, payor information and insurance providers from a variety of sources including electronic client database, eligibility websites, and our own customer database.
• Ensure timely input of information into our pharmacy fulfillment software based on information to assure on-time fulfillment of prescription to the patient.
• Communicate efficiently and effectively with team members, pharmacists, nursing facility staff and insurance companies.
• Triage accounts by patient demographic and insurance information.
• Coordinate Discharge process within pharmacy software system when appropriate.
• Research system for member eligibility. Create and record patient and insurance information.
• Adhere to the departmental processes associated with the documentation and review of insurance information.
• Escalate issues pertaining to workflow to Manager of Intake and Admissions.
• Call provider or facility for any additional information necessary to the creation of an account to update regarding member eligibility, and to provide them with the information as indicated.
• Actively contributes to the evaluation and continuous improvement of client services, policies and procedures.
• The ability to adhere to Clarest’s Code of Conduct, follow Clarest Compliance policies and procedures, and report any suspected violations of any federal or state laws to either their direct supervisor, Human Resources or the Compliance Officer
• Any and other responsibilities as assigned by the manager to support these and other responsibilities in the department.

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of this employee for this role.

Required Skills (Education/Certification/ Licenses/Years of Experience):

• High school diploma or equivalent, required.
• Knowledge of Medicare Part D, Medicaid and Commercial insurances, required.
• Intermediate knowledge of Microsoft Outlook, and Teams, required.
• Intermediate experience with Framework LTC and DocuTrack preferred.
• Ability to maintain confidentiality including but not limited to HIPPA.

Competencies:

• Critical thinking and problem-solving skills, required.
• Ability to multi-task and prioritize in a fast-paced environment.
• Ability to handle a high number of accounts per day.
• Courteous, empathic, and professional demeanor, a team player.
• Strong communication, interpersonal, and organizational skills.
• Receptive to feedback, willing to learn, embracing continuous improvement.

Supervisory Responsibility: None

Budget Responsibility: None

Describe the nature and scope of independent decisions made in this position:

Ability to evaluate process path based off information obtained from insurance or another payer. Responsible for managing queue of workload and reporting any concerns to leadership.

Work Environment:

This job is performed remotely and requires a dedicated, secure workspace where PHI cannot be easily accessed. Hardwired high-speed internet is required, no Wi-Fi.

All equipment will be supplied by the employer. (Computer, keyboard, mouse, monitors, audio/video phone calls,).

Physical Demands: Deskwork, sitting for long periods, extended periods of screen time, and phones. No heavy lifting is required.

Position Type/Expected Hours: The role is a full-time, hourly rate, 40-hour-per-week Monday through Friday position.

Travel (if yes, percentage of travel time required): None

Other unique responsibilities or conditions not previously addressed (driver’s license, bilingual, etc.): None

Clarest is an Equal Opportunity Employer. Reasonable accommodations will be made to enable individuals with disabilities to apply for a job or to perform the essential functions of their job. Please advise us if you require a reasonable accommodation.