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We are seeking a **_Retina Drug Coordinator_** who will manage all administrative aspects of the patient encounter involving intravitreal injection therapy. This includes accurate data entry on each patient to facilitate the appropriate pre-certification of therapy, expediting the check-in / check-out process, and afford appropriate billing.

Specific Duties & Responsibilities

+ Confirms all needed forms are up to date, and signed (Outpatient agreement, consents)

+ Obtains pre-certification as required by patient’s healthcare insurer or managed care provider.

+ Obtains preauthorization for retina drug injections with following the insurance guidelines process.

+ Checks over provider schedules 2 weeks in advance for errors and repeats within 48 hours of date of service for any urgent additions.

+ Follows payer guidelines.

+ Follows ICD-10 codes to ensure diagnosis codes are appropriate for each retina drug prior to claim submission.

+ Follows limiting coverage guidelines for diagnosis coding by using LCD/NCD/payer policy information and assigns appropriate modifiers based on departmental policy.

+ Maintains familiarity with various types of insurances. Contacts insurance carriers for clarification of coverages to avoid denials of payment.

+ Monitors and responds to assigned work queues.

+ Provides support to both East Baltimore and satellite clinics during events of short staffing ( sickness, vacation, meetings)

+ Guides patients and families to appropriate resources (financial counselors, international office, social worker, drug copay assistance programs)

+ Assists in enrolling patients in drug copay assistance programs and tracking payments.

+ Verifies insurance information for each injection scheduled.

+ Works closely with both Wilmer billing and Office of Managed Care to keep abreast of ever- changing payor procedures

+ Works closely with Wilmer IT for continued evaluation of EPIC documentation and workflows needed to improve communication errors adding to ultimate denials.

+ Reviews with patients all pre / post procedure instructions and assists with necessary forms for completion. Obtains needed signatures and scans documents into Epic.

+ Reviews with patients all insurance requirements before procedure and works with the patient and billing office to ensure all proper financial arrangements have been made.

+ For international patients, works with the International Office to ensure financial clearance and scheduling.

+ Ensures that all patient questions have been answered by the appropriate staff.

+ Coordinates details for each procedure, inclusive of time sensitive appointments for series injections.

+ Works with financial clearance and production unit staff to assist patients in financial need.

+ Works with social worker to assist patients with resource challenges.

+ Works with the staff to develop, implement and manage systems to ensure all required components are completed for intravitreal treatment patients, i.e., consents and waivers.

+ Speaks to each patient in a kind and professional manner.

+ Works collaboratively with others.

Minimum Qualifications

+ High school diploma or graduation equivalent.

+ Three years of related experience.

+ Additional education may substitute for required experience, and additional related experience may substitute for required education beyond a high school diploma/Graduation Equivalent, to the extent permitted by the JHU equivalency formula.

Preferred Qualifications

+ Two years’ experience in related field and/or JHHS entity preferred.

+ Knowledge of medical insurance and/or medical terminology preferred.

Classified Title: Clinical Program Coordinator

Job Posting Title (Working Title): Retina Drug Coordinator

Role/Level/Range: ATO 40/E/03/OE

Starting Salary Range: $18.20 - $33.90 HRLY ($29.00/hour targeted; Commensurate w/exp)

Employee group: Full Time

Schedule: Mon-Fri, 8:30am-5:00pm

FLSA Status: Non-Exempt

Department name: SOM Oph Retina Service

Personnel area: School of Medicine

The listed salary range represents the minimum and maximum Johns Hopkins University offers for this position, based on a good faith estimate at the time of posting. Actual compensation will vary depending on factors such as location, skills, experience, market conditions, education, and internal equity. Not all candidates will qualify for the highest salary in the range.

Johns Hopkins provides a comprehensive benefits package supporting health, career, and retirement. Learn more: https://hr.jhu.edu/benefits-worklife/.

Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

EEO is the Law

https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf