Medicare Part B/Authorization Specialist

Upstate University Hospital   Syracuse, NY   Full-time
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Medicare Part B/Authorization Specialist

Apply now Job no: 70562
Department: Pharmacy-Retail
Employer: State of New York
Payroll Title: TH Staff Assistant 1, NSSL2
Bargaining Unit: UUP (State University Professional Services Unit)
Salary: Commensurate with Qualifications
Work type: Full-time
Location: Syracuse
Categories: Allied Health

Job Summary: Oversee all Medicare Part B claims being submitted at the SUNY Outpatient Pharmacy locations to ensure optimal reimbursement for high cost, take home medications and covered supplies for patients receiving care in the Upstate Medical University and Health Clinics. Manage and assist staff, workflow, and training of all items related to Medicare Part B claims. Coordinate with clinic, pharmacy staff, and additional teams to provide patients with their take home medications efficiently and timely. Obtain all Medicare Part B required documentation and appropriately import documentation into the correct charts. For Transplant related Medicare Part B requests, request approval from Medicare to process claim and supply a full list of medication costs prior to discharge to the Transplant clinic in order to help cover any unforeseen charges that may occur. Assist Patient Care Coordinators and clinic-based technicians in confirming patient eligibility, including primary and secondary/supplemental insurance for Part B claims. Aid pharmacy technicians at SUNY Outpatient Pharmacy, inputting overrides when appropriate. Oversee and manage the process, policy development for DME Medicare accreditation. Manage the prior authorization coordinators who responsibility includes hospital owned outpatient pharmacies.
Minimum Qualifications:

Associate's Degree in a science or health related field and three years of pharmacy experience, OR equivalent combination of education and like experience required. National Pharmacy Technician Certification required. Excellent written/oral communication, interpersonal, organizational, conflict resolution, and computer skills required.

Preferred Qualifications:

Experience with medication reimbursement, medications, physician orders and insurance claim submissions preferred. Experience with healthcare insurance prior authorization/coding and performing insurance carrier/managed care review preferred.

Work Days:

Monday-Friday, 8 am-4:30 pm

Message to Applicants:  
Recruitment  Office: Human Resources
Executive Order: Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation. If such information has been requested from you before such time, please contact the Governor's Office of Employee Relations at (518) 474-6988 or via email at info@goer.ny.gov.              

 

 

We are an Equal Opportunity Employer.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran status or disability or other protected classes under State and Federal law.

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Upstate University Hospital

Syracuse, NY