Why You'll Love this Job
Retina Consultants of Texas (RCTX) is seeking a Drug Senior Team Lead to act as the Lead for the Drug Coordinator Team. The Team Lead is the first point of contact for the Drug Team and will partner with the department leader to escalate team and patient concerns. As Senior Lead you will be responsible for managing a team. Candidate must be able to support variable hours (Monday - Friday, 8:00 am to 5:30 pm).
Retina Consultants of Texas is the largest and most respected retina-only ophthalmology practice in the United States. Our group consists of 26 world-renowned physicians leading the world in retinal care. While serving two major metropolitan markets (and their extensions) our combined culture allows us to best serve our patients, referral sources and our own team of physicians. RCTX also invests heavily in diagnostic equipment, providing state-of-the-art retina imaging, laser, and diagnostic capabilities to each patient. This, combined with the clinical expertise of our physicians, an outstanding and devoted staff, and 25 convenient locations to serve our patients.
We worked hard to create our culture as Retina Warriors. We strongly emphasize our core values of Hard Work, Authentic Care and Innovation in everything we do. It is our belief that by investing in our people, our people will be empowered of their own accord to provide the highest quality patient experience.
In addition to being highly challenged professionally, in joining our practice, the following competitive benefits for full-time eligible employees after a 60-day introductory period:
- Employee Paid Benefits such as Medical, Dental, and Vision, short-term disability, voluntary life insurance, accident, critical illness, hospital indemnity, pet insurance, HSA pre-taxed contributions, 401 (k) retirement savings contributions (both Roth and Traditional options) from starting date of hire.
- Employer Paid Benefits such as long-term disability, $25,000 basic life insurance policy, 3% 401(k) safe harbor contribution, HSA employer contributions, annual performance merit increases, certification opportunities, rewards & recognition platform, WellHub Starter Plan Gym Membership, paid time off and (8) paid holidays + (1) floating holiday annually.
Pay Rate is $24.00+ per hour and eligible for overtime.
RCTX is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, sexual orientation, age, national origin, disability, military service, veteran status, genetic information, or any other protected class under applicable law.
Responsibilities
- Acts as the first point of contact for the team to work through and resolve patient complaints or concerns, process improvement ideas, system issues, and general inquiries.
- Approve Timesheets and reimbursements.
- Oversees the team’s work schedule, approve PTO requests, call-outs, and FMLA requests.
- Performs yearly performance reviews.
- Administers Disciplinary actions when needed.
- Creates and updates department standard operating procedures (SOPs).
- Review daily work logs
- Oversees department tasks to ensure they are completed on time
- Coordinates monthly team meetings with the RCM manager
- Participates in weekly Team Lead Meetings
- Partner with Revenue Cycle Trainer to develop training materials and agenda for onboarding new hires.
- Partners with the leader to create programs to reward and incentivize the team to reach business goals
- Conduct benefit investigations, verify insurance benefits for patients, and submit and obtain prior authorizations as required by the payor; obtain recertification for cases requiring extended treatment/coverage beyond the expiration of original approval.
- Accurately review, obtain, enter, and maintain co-pay assistance data as required in client database and patient files and utilize the client database to monitor outstanding items on each patient to ensure tasks are complete to determine the current status.
- Participate in conference calls as needed with Drug Vendor Representatives, drug orders, and status of alternative funding.
- Provide coordination of order for product, shipment of product, and therapy initiation with pharmacy and patient.
- Participate in Call Center Activities, triage, and respond to incoming calls from patients, insurance companies, physicians, Vendor Representatives, and pharmacies. May serve as a single point of contact for an assigned group of prescribers.
- Identify and report events as required by the Revenue Cycle Manager requirements for specified medication. Recognize adverse events, product quality complaints, and potential risk events, and forward information to the appropriate team member for reporting to the manufacturer.
- Performs Level 10 Meetings with their respective teams.
- Visit Clinics Quarterly
- Educate patients, prescribers, and others regarding program requirements, and facilitate referrals.
- Maintain good housekeeping techniques, adhering to quality and production standards and comply with all applicable company, state, and federal safety and environmental programs and procedures.
- Other duties as assigned.
Qualifications
Skills/Competencies:
- Computer proficiency in MS Office applications, with Electronic Health Records/Practice Management experience a plus.
- Excellent written and verbal communication skills, with demonstrated ability to communicate with others at all levels.
- Ability to manage multiple priorities in a fast-paced environment and meet deadlines.
- Organized, Detail oriented with good analytical skills.
- Knowledge of third-party billing, coding, medical terminology, prior authorizations, and appeals preferred.
Education Requirements
- High School diploma or equivalent required
- Bachelors Degree preferred
Experience Requirements:
- 2 years of experience here at RCTX or in the insurance, biotechnology, or pharmaceutical industries; customer service and/or reimbursement preferred
- 1-year experience as Team Lead at RCTX
- Health Insurance claims or patient accounting experience a plus
Physical Abilities:
- Prolonged periods sitting at a desk and working on a computer.
- Must be able to lift up to 15 pounds at times.