Specialty Pharmacy Account Coordinator - Mercy Riverport Pharmacy Job Listing at Mercy in Maryland Heights, MO (Job ID JR2533502)

Description

Find your calling at Mercy! TheSpecialty Account Coordinator Iis responsible for multiple facets of patient account coordinationincluding insurance/benefit verification, rejection and denials management and collections. The Specialty Account Coordinator is also responsible for knowing which assistance programs, such as drug copay cards and/or foundations, patients may qualify for, assisting patients in enrolling in thoseprograms, monitoring services rendered and billing the assistance programs for the applicablefunds. This position requires a thorough understanding of all available programs, funding guidelines, claims procedures and insurance company regulations, as well as oncology coding and billing. This position monitors insurance company regulations for changes in pre-certification, documentation, medical necessity criteria, policy requirements and/or claims submission requirements. This position requires accuracy, attention to detail and the ability to communicate well with physicians, staff, patients, and insurance companies. The Specialty Account Coordinator I serves as a resource for other staff and patients. This position serves as a Senior Pharmacy Technician as needed. Performs duties in a manner consistent with Mercy Service Standards. Position Details: Specialty Pharmacy Account Coordinator I

Location: Mercy Riverport Pharmacy
Schedule: Full-time (40 hours/week), Monday–Friday

The Specialty Pharmacy Account Coordinator I is responsible for comprehensive patient account coordination, including insurance and benefit verification, denial and rejection management, collections, and patient financial assistance. This role requires strong knowledge of specialty pharmacy billing and oncology-related coverage requirements, as well as the ability to communicate effectively with patients, providers, internal teams, and insurance carriers. The Coordinator also serves as a resource to staff and may function in a Senior Pharmacy Technician capacity as needed. All duties are performed in accordance with Mercy Service Standards and applicable federal and state regulations under the supervision of a licensed pharmacist.

Patient Account & Insurance Coordination

• Verify and document patient insurance eligibility, benefits, and pre-certification requirements, including infused medications
• Ensure medical necessity and coverage compliance with insurance carrier policies, FDA guidance, NCCN, and other national guidelines
• Monitor payer policy changes related to pre-certification, documentation, medical necessity criteria, and claims submission

Financial Assistance & Manufacturer Programs

• Identify applicable patient assistance programs, including copay cards and foundations
• Assist patients with application completion and enrollment, collecting required patient, financial, and physician documentation
• Track submissions to ensure timely review and approval by assistance programs
• Register patients for manufacturer copay card programs per guidelines
• Coordinate drug replacement programs and manufacturer appeals when applicable

Denials & Appeals Management

• Research and manage insurance denials, identifying root causes
• Collaborate with leadership to recommend process improvements, staff training, workflow enhancements, and system corrections
• Work with pharmaceutical manufacturers to support insurance appeals prior to drug replacement

Workflow, Quality & Leadership Support

• Process oncology patient accounts efficiently, maintaining high accuracy and productivity
• Monitor workflow, conduct quality audits, and assist with staff development
• Address complex patient or program issues and serve as a subject matter resource
• Recommend improvements to procedures, training guides, and operational processes
• Participate in task forces and assist with implementation of new programs or systems

Pharmacy Technician Responsibilities (as needed)

• Prepare and fill medication orders under pharmacist supervision
• Retrieve, count, mix, and dispense medications accurately and efficiently
• Maintain and secure pharmacy inventory
• Deliver medications following pharmacist verification
• Retrieve unused medications and process credits when appropriate
• Participate in medication use evaluations and quality assurance activities

• Complete all mandatory hospital and department education and competency requirements
• Maintain proficiency in pharmacy systems, adjudication, financial assistance, POS, ordering, and inventory management
• Identify drug-use-related issues and propose constructive solutions
• Demonstrate the ability to train and orient new staff

Education

• Some college coursework in Business, Finance, Accounting, or a related field preferred

Licensure & Certification

• Current State Pharmacy Technician license in good standing
• Pharmacy Technician Certification (CPhT) required within six months of hire

Experience

• Minimum of 3 years of related experience, including at least 1 year of pharmacy experience

Knowledge, Skills & Abilities

• Strong interpersonal, organizational, and analytical skills
• Ability to work accurately in fast‑paced, high‑stress environments
• Sound judgment and problem‑solving skills
• Effective written and verbal communication abilities
• Ability to collaborate with leadership and cross‑functional teams in demanding situations

From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period.

Join a caring, collaborative team where your voice matters. At Mercy, you'll help shape the future of healthcare through innovation, technology, and compassion. As we grow, you'll grow with us.