Specialty Pharmacy Account Coordinator - Mercy Riverport Pharmacy

Mercy

Maryland Heights, MO

JOB DETAILS
SKILLS
Accounting, Adjudication Systems, Analysis Skills, Auditing, Billing, Certified Pharmacy Technician (CPhT), Co-Payments, Communication Skills, Credit Processing, Credit and Collections, Denials Management, Detail Oriented, Documentation, Drug Manufacturing, Federal Laws and Regulations, Finance, Funding, Healthcare, Hospital, Insurance, Insurance Claims, Insurance Documentation, Insurance Regulations, Interpersonal Skills, Inventory Management, Leadership, License Management, Medical Billing, Medications, Monitor Regulations, Oncology, Operations Processes, Organizational Skills, Patient Care Denials, Patient Registration, Pharmacy, Presentation/Verbal Skills, Problem Solving Skills, Procedure Development, Process Improvement, Project/Program Coordination, Quality Assurance, Root Cause Analysis, Staff Development, Staff Training, State Laws and Regulations, Systems Maintenance, Team Player, Time Management, Writing Skills
LOCATION
Maryland Heights, MO
POSTED
3 days ago

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

Position Summary

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.

Key Responsibilities

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

Orientation, Training & Performance

  • 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

Qualifications

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

Why Mercy?

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.

About the Company

M

Mercy

Our Mercy health system was founded by the Sisters of Mercy in 1986. But our heritage goes back more than 185 years. It began with an Irish woman named Catherine McAuley, who wanted to help the poor women and children of Dublin. Though Catherine had a modest upbringing, she received an unexpected inheritance that allowed her to fulfill her dreams. In 1827, she opened the first House of Mercy in Dublin, intending to teach skills to poor women and educate children. Many volunteers came to help. A few years later, Catherine founded the Sisters of Mercy, the first religious order not bound to the rules of the cloister, whose Sisters were free to walk among the poor and visit them in their homes. By the time Catherine died in 1841, there were convents in Ireland and England, and in 1843, the Sisters of Mercy came to the United States. In 1871, they traveled to St. Louis and from there throughout the Midwest, beginning what would, today be known as Mercy.

Mercy, named one of the top five large U.S. health systems in 2018, 2017 and 2016 by IBM Watson Health, serves millions annually. Mercy includes more than 40 acute care and specialty (heart, children’s, orthopedic and rehab) hospitals, 800 physician practices and outpatient facilities, 44,000 co-workers and 2,100 Mercy Clinic physicians in Arkansas, Kansas, Missouri and Oklahoma. Mercy also has clinics, outpatient services and outreach ministries in Arkansas, Louisiana, Mississippi and Texas. In addition, Mercy's IT division, Mercy Technology Services, supply chain organization, ROi, and Mercy Virtual commercially serve providers and patients in more than 20 states coast to coast.

COMPANY SIZE
10,000 employees or more
INDUSTRY
Healthcare Services
FOUNDED
1986
WEBSITE
https://www.mercy.net/