Pharm Tech - Patient Access Coordinator
Perform duties to assist patients with access to benefits and co-pay cards, and schedule delivery of prescriptions provided through the specialty pharmacy, working within the limits of standard or accepted practice.
- Communicate with patients to obtain information required to process prescriptions, refills, access benefits and apply charges against co-pay cards, and build trusted and enduring customer relationships that yield loyalty.
- Investigate and verify benefits for pharmacy and medical third party claims for assigned cases. May communicate with financial assistance team of drug manufacturers to apply for and secure financial assistance for patient when assigned.
- Obtain prior authorizations; initiate requests, follow up to provide additionally required information, track progress, and expedite responses from insurance carriers and other payers, and maintain contact with customers to keep them continuously informed.
- Track, report and escalate service issues arising from requests for authorizations, financial assistance or other issues that delay service, to ensure patient access and to avoid delays that may interrupt therapy.
- Schedule delivery of pharmaceuticals to suit patient needs and payer requirements.
- Communicate clinical inquiries to pharmacy or nursing team and arrange for direct patient communication or provide responses to patients, as appropriate. Identify opportunities for counseling by Registered Pharmacists or Nurse Counselors and make referrals as appropriate.
- Build and maintain effective business relationships with prescribers treating assigned set of disease states, and provide ongoing communication of specific case-related information as appropriate.
- Perform or assist with any operations, as required to maintain workflow and to meet schedules and quality requirements.
- Participate in any variety of meetings and work groups to integrate activities, communicate issues, obtain approvals, resolve problems and maintain specified level of knowledge pertaining to new developments, requirements, and policies.
- Perform other related duties as assigned.
- Extraordinary telephone customer service skills with the ability to build effective, appropriate and enduring customer and provider relationships.
- Strong organization and case administration skills.
- Excellent knowledge of insurance benefit investigation process and techniques.
- Demonstrated case ownership orientation with the ability to manage a range of priorities and meet time commitments.
- Excellent Microsoft Office and data management software skills with demonstrated adaptability to internal systems (CPR+).
- Demonstrated strength in listening, oral and written communications in English.
Education and Experience Requirements:
- Basic High School and additional specialized training in pharmacy/medical benefit access and requirements.
- 1 to 3 years of experience in healthcare customer service with knowledge of benefits access processes.
- Insurance verification.
- Experience with prior authorizations.
- Benefits investigations.
- Pharmacy Tech License