You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Responsible for reviewing the quality of work produced by the referral management and intake teams. Information and materials generated from these departments will be for final review by the Intake Director and Quality Control Coordinator. This includes, but is not limited to, verification of customer insurance, healthcare claim submissions, PDP and Medical prior authorizations, and other related work. Direct communication with insurance organizations may be required.

Insurance Operational Review

• Insurance Verification and entry into Care Tend
  • Prior Authorization completion in CT
  • Preparation for Claim Submission
  • Intake Workflow
  • Copay Assistance / billing
  • Insurance software

Administrative & Billing Support

• Performs a variety of office functions, such as filing, typing, copying, data entry, research, etc.
• Maintains various Billing files in proper order billing and financial operations.
• Nursing Software/Nursing Note Submission & Nurse tracking.
• Billing preparations for nursing notes

Professionalism & Compliance

• Adheres to confidentiality, safety, compliance, and legal requirements.
• Ongoing Communication with Referral Management, Billing, Insurance Verification, and Data Entry.
• Assists in appropriate product selection by understanding all payers, reimbursement, and formularies.
• Comply with company deadlines and inventory standards to meet compliance standards.
• Consistently represents the company in a professional manner and maintains effective working relationships.
• Participate in administrative staff meetings and attend other seminars as required.

Required Skills

• Minimum two years in healthcare environment, preferably within Pharmacy. 
• (Preferred) Active TX State Pharmacy Technician Licensure and National Certification
• Ability to work independently and within a multidisciplinary team
• Highest level of professionalism, responsiveness, and communication skills
• Ability to multi-task and frequently change direction as required
• Ability to work fully onsite, Monday - Friday 8:30 am to 5 pm CST. 

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients