Requisition: 2024-133914

　　MANAGER, BENEFIT INVESTIGATION

　　Job LocationsUS-KY-LOUISVILLE

　　Our CompanyAmerita

　　OverviewThe Manager of Benefit Investigation is responsible for oversight of activities relating to the proper loading and investigation of patient prescription benefits, including but not limited to medical and pharmacy coverage, investigation of authorization requirements needed to obtain medical coverage, as well as obtaining patient copay card assistance based on program eligibility criteria. This role requires advanced program knowledge of benefit verification, prior authorization, and claims adjudication, and will provide quality control by routinely examining cases completed by team members, reviews of No-Go trends, and operations process reviews pertaining to patient benefits.

　　This is a remote position. Applicants can reside anywhere in the continental USA.

　　We offer:

　　DailyPay

　　Flexible schedules

　　Competitive pay

　　Shift differential

　　Health, dental, vision and life insurance benefits

　　Company paid STD and LTD

　　Tuition Assistance

　　Employee Discount Program

　　401k

　　Paid-time off

　　Tuition reimbursement

　　Non-retail/Closed-door environment

　　ResponsibilitiesSupervises BI staff in a leadership role to maintain a positive working environment by creating synergy and teamwork to minimize employee relations issues and reduce turnover. Communicates effectively across pharmacy and/or corporate teams and with patients, and successfully resolves issues

　　Assists Director of Operations - Workflow in day-to-day pharmacy operations and in implementing new procedures to ensure that the accurate and timely dispensing of quality pharmacy services is consistently delivered to all patients using effective service leadership and customer skillsWorks with pharmacy management to recruit, select, hire, orientate, develop, and train new associatesOn an ongoing basis, evaluates, coaches, and utilizes performance management practices to motivate and set expectation for intake staffIn collaboration with management, drafts and delivers effective corrective action plans and disciplinary action to technicians performing at substandard levelsManages and reports on activity of vertical team members, including managing of daily workflow and productivity trendsMonitors and validates adherence to Policies and Procedures within the BI team, auditing as necessary to ensure productivity and performance to goals are accomplished or exceededReviews Gold Standard Initiative operational process and workflow queues to find opportunities to enhance intake process and coordinate with Director of Operations - Workflow to approve and roll out changes/ updatesManages and maintains web tools utilized by the BI team and offers frontline support to address system functionality questions and issues (ex: provider eligibility portals, copay card portals, applications, etc.)Manages communication, assignments, process updates and feedback for any off-site team in the benefit investigation queuesKnowledgeable to perform all Benefit Investigation functions and resolves escalations regarding difficult cases. Provides thorough, accurate and timely responses to requestsImplements and follows up on progress of any operational changes and updates to the document management process with the benefit investigation team and key stakeholdersWorks with Director of Operations - Workflow on other responsibilities, projects, implementations, and initiatives as neededMaintains a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality lawsContributes to team effort by accomplishing related tasks as needed and other duties as assignedConducts job responsibilities in accordance with standards set out in the Company's Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards

　　QualificationsHigh School Diploma/GED, previous experience in pharmacy, medical billing, or benefits verification5+ years pharmacy experience, 1+ years supervisor experience requiredExcellent interpersonal skills, able to work with all levels of management and staff, vast knowledge of pharmacy insurance and benefit verificationAbility to multitask in a demanding environmentExcellent organizational skills and mindfulness

　　About our Line of BusinessAmerita is a specialty infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. Committed to excellent service, our vision is to combine the administrative efficiencies of a large organization with the flexibility, responsiveness and entrepreneurial spirit of a local provider. For more information about Amerita, please visit www.ameritaiv.com. Follow us on TwitterandLinkedIn.

　　Salary RangeUSD $67,760.00 - $84,700.00 / Year

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　　Res-Care, Inc., dba BrightSpring Health Services (“ResCare”), is an Equal Opportunity Employer. ResCare does not discriminate against any person on the basis of gender, r ace, color, national origin, r eligion, disability, age, veteran status, gender identity or s exual orientation in admission, treatment, or participation in its programs, services and activities, or in employment, or on the basis of gender in its health programs and activities.