Insurance Coordinator
Job Description
The Pharmacy Insurance Coordinator is responsible for managing the end-to-end insurance approval process, ensuring accurate billing, and liaising between the pharmacy, patients, and insurance providers to guarantee seamless reimbursement and compliance with DHA and payer regulations.
Key Responsibilities:
Process insurance claims (OTC, pre-approvals, and reimbursements) accurately and promptly.
Verify patient eligibility and coverage details before dispensing medications.
Coordinate with insurance companies (network providers) to resolve rejections, denials, or discrepancies.
Ensure all documentation aligns with DHA, HAAD, and insurance company standards.
Maintain accurate records of all transactions and claims submissions.
Advise pharmacy staff and patients on insurance coverage limitations and co-payments.
Follow up on outstanding claims and manage the revenue cycle management (RCM) for the pharmacy department.
Requirements
Minimum 2 years in a pharmacy or healthcare insurance setting
Summary
Experience Required:
2 year(s) minimum
