Specialty Pharmacy Account Coordinator - Riverport Location Job Listing at Mercy in Maryland Heights, MO (Job ID JR2226842)

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:

Job Title: Specialty Pharmacy Account Coordinator I
Location: Mercy Specialty Pharmacy – Riverport I
Schedule: Full-time | Monday–Friday | 8:00 AM – 5:00 PM

Overview:
The Specialty Pharmacy Account Coordinator I plays a critical role in supporting patients through complex medication therapies by coordinating insurance, financial assistance, and pharmacy services. This position works under the direct supervision of a pharmacist and in compliance with all federal and state regulations.

Key Responsibilities:

• Patient Account Coordination:

  • Process patient accounts efficiently and accurately in assigned sections.
  • Verify insurance eligibility, benefits, and pre-certification requirements, including for infused medications.
  • Ensure compliance with medical necessity criteria and payer policies (e.g., FDA, NCCN).
  • Manage denials, identify root causes, and recommend process improvements.

• Financial Assistance & Program Management:

  • Identify and enroll patients in applicable assistance programs (e.g., copay cards, foundations, PAPs).
  • Collect and submit required documentation on behalf of patients.
  • Track application status and ensure timely follow-up.
  • Register patients for drug replacement programs and appeal insurance denials when necessary.

• Pharmacy Operations Support:

  • Function as a Senior Pharmacy Technician as needed.
  • Prepare and fill medication orders under pharmacist supervision.
  • Maintain and secure drug inventory; deliver medications post-verification.
  • Retrieve and credit unused medications appropriately.

• Leadership & Quality Assurance:

  • Monitor workflow and conduct quality audits.
  • Assist in training and development of coworkers.
  • Lead task forces and contribute to new program implementation.
  • Recommend and help implement procedural improvements.

• Communication & Collaboration:

  • Serve as a resource for staff and patients.
  • Communicate effectively with physicians, insurance companies, and internal teams.
  • Address complex patient concerns and model professional behavior.

• Compliance & Development:

  • Stay current on insurance regulations and billing guidelines.
  • Complete all mandatory training and pharmacy competencies.
  • Participate in quality assurance and medication use evaluation programs.

Qualifications:

• High school diploma or equivalent required; associate degree or higher preferred.
• Experience in pharmacy operations, insurance verification, or healthcare billing strongly preferred.
• Strong knowledge of specialty pharmacy, oncology billing, and patient assistance programs.
• Excellent communication, organizational, and problem-solving skills.
• Proficiency in pharmacy systems and Microsoft Office Suite.

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.