Patient Services Specialist | Therapy | PRN at Abarca Health

Mitchell, South Dakota, United States

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Not SpecifiedCompensation

Entry Level & New GradExperience Level

Part TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Technical Certificate: One year certificate from college or technical school; related experience and/or training; or equivalent combination of education and experience
Less than 1 year related experience and/or training; or equivalent combination of education and experience
Visual acuity adequate to perform position duties
Ability to communicate effectively with others, hear, understand, and distinguish speech and other sounds
Ability to work the hours specified (PRN, as needed)
Preferred: High School or GED Equivalent

Responsibilities

Serves as support liaison with current Patient Service Representatives and patients
Assists with patient check-in and collection of co-pays
Works and communicates with insurance companies or appropriate entity to ensure prior authorization for procedures is received
Completes ordering for all supplies for the office and monitors expiration dates on items that expire, if applicable
Completes templates for the providers' schedule when necessary
Assists in registering patients, collecting co-pays and patient balances at time of service
Completes prior authorizations as requested by providers, nursing staff, and insurance companies
Assists patients with preparation and completion of appropriate paperwork for financial assistance
May be cross-trained into other functions to assist in the patient care delivery system
Runs reports to track communication information with providers and administration
Manages and monitors the credentialing processes for providers including Physicians and Advanced Practice Providers associated with the practice, if applicable
Commitment to Avera’s mission, vision, core values, and social principles
Promotes Avera’s values of compassion, hospitality, and stewardship
Upholds Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE)
Maintains confidentiality
Works effectively in a team environment, coordinating workflow with other team members
Complies with safety principles, laws, regulations, and standards (e.g., CMS, The Joint Commission, DHHS, OSHA)

Skills

Patient Registration

Co-pay Collection

Prior Authorization

Insurance Communication

Credentialing

Supply Ordering

Scheduling

Report Running

Financial Assistance Paperwork

Abarca Health

Pharmacy Benefit Management services provider

About Abarca Health

Abarca Health provides Pharmacy Benefit Management (PBM) services, focusing on flexible and user-friendly solutions for health plans, employers, and government programs like Medicare and Medicaid. Its main product, the Darwin platform, allows clients to quickly implement and modify benefit designs while ensuring compliance with regulations. Abarca Health manages over $5.3 billion in drug spend and processes 100 million prescription claims annually, offering additional services like home delivery for prescriptions. The company's goal is to deliver exceptional service and innovative solutions in the PBM market.

Aventura, FloridaHeadquarters

2005Year Founded

VENTURE_UNKNOWNCompany Stage

HealthcareIndustries

501-1,000Employees

Benefits

PTO

Parental leave

Work flexibility

Health insurance

Wellness stipend

401k

Tuition reimbursement

Leadership development programs

Risks

Increased competition from Amazon Pharmacy and Mark Cuban's Cost Plus Drug Company.

Growing focus on specialty drugs may require platform adaptation.

Shift towards price transparency could pressure Abarca's pricing models.

Differentiation

Abarca Health's Darwin platform is highly adaptable and user-friendly.

The company offers innovative programs like Triple S en Casa for home delivery.

Abarca Health ensures compliance with ever-changing healthcare regulations.

Upsides

Abarca transitioned two million members to Darwin in 18 months, showing operational efficiency.

Collaboration with Blue Shield of California boosts Abarca's reputation in the PBM sector.

Recognition as a top IT workplace attracts top talent, driving innovation.

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