Patient Support Spec

GENERAL DESCRIPTION

The Patient Support Specialist is responsible for maintaining on-going patient care through the support of patient outreach and prescription refill management services throughout the patient’s specialty or infusion therapy. Refill management support may include but is not limited to overseeing the intake or gathering of patient documentation, obtaining new prescriptions as needed for patients to continue therapy, communicating with doctors’ offices and patients, submitting insurance re-authorizations and assisting the pharmacy operations team on a daily basis. This position requires professional communication skills and compliance with all applicable laws and regulations, including state board of pharmacy and HIPAA.

QUALIFICATION REQUIREMENTS

• Current Pharmacy Technician registration and/or certification in good standing, as required by
  state Board of Pharmacy
  • or commitment to obtaining necessary BoP registration/certification within first 60
    days of employment
• Experience providing customer service to internal and external customers, including meeting
  quality standards for services, and evaluation of customer satisfaction
• Experience with data entry, navigation of technology to support work environment, and general
  familiarity with medical terminology
• Basic level skill in Microsoft Office (including Word, Excel, PowerPoint, etc)

QUALIFICATIONS PREFERRED

• High School diploma or equivalent strongly preferred
• Pharmacy Technician certification (unless required by State Board of Pharmacy)
• Direct patient care and/or experience communicating with patient care settings such as
  healthcare practices, inpatient, outpatient, skilled nursing, and/or home care settings
• Minimum of 1 year of experience in Specialty pharmacy
  
  

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Patient Support Responsibilities:

• Contact patients to set up prescription refills while gathering necessary data points to support
  refill process
• Submit for insurance re-authorizations as needed
• Obtain necessary documentation from doctors’ offices and/or patients, to include lab work,
  prescription refills, etc., while following all legal requirements
• Ensure clinical compliance of patients by asking pre-determined questions and escalating to a
  pharmacist when necessary
• Refer all clinical questions, situations, and responses to a pharmacist
• Communicate professionally with both patients and doctor offices while following all legal
  requirements, to include state pharmacy regulations and HIPAA
• Responsible for maintaining relationships with doctor’s offices to include:
  • Appropriate communication with offices as required and permitted by law
  • Communication with field-based sales representative while adhering to HIPAA
    requirements
  • Customizing services where possible in accordance with office preferences
• Stay up to date with appropriate level of clinical knowledge of applicable disease states
• Support other technicians, acting as mentor and trainer when appropriate
• Assist pharmacy operations teams as needed
  
  

Pharmacy Related Competencies:

• Maintain knowledge of and comply with the regulatory guidelines and standards of practice
  of the State Board of Pharmacy, FDA, DEA, Department of Health & Human Services,
  Medicare, ACHC, URAC and OSHA as applicable to pharmacy location
• Communicate with physicians, patients and insurance companies within legal limits according
  to state, communicating professionally at all times and complying with HIPAA regulations
• Triage patient and pharmacist related questions and channel to the appropriate person
• Support, upon request, production/dispensing/shipping duties in an accurate and timely
  manner as permitted by law and under the supervision of a pharmacist
• Additional duties may be assigned by management

Data Entry Responsibilities:

• Process all faxes and E-script orders
• Manage and process all refills
• Input all demographic and insurance information
• Verify eligibility and specific drug coverage
• Work on prior authorizations and insurance over-rides as instructed
• Run appropriate labels
• Support refill or delivery coordination reminders using designated technology

NON-ESSENTIAL FUNCTIONS & RESPONSIBILITIES

• Ability to prioritize and handle multiple tasks and projects concurrently
• Must have scheduling flexibility and be able to work overtime as needed
• Careful attention to detail
• Performs related duties as requested
• Participates in quality assurance activities and audits as directed
• Participation in membership of professional societies or organizations as deemed helpful or
  necessary for role
  
  

KNOWLEDGE, SKILLS AND ABILITIES REQUIREMENTS

Customer Service Skills:

• Strong phone skills, speaks clearly, supports active listening, and manages call flow effectively
  meeting the needs of the caller as effectively and efficiently as possible
• Strong ability to build and maintain contacts and effective working relationships with internal
  and external customers including patients, caregivers, healthcare service providers, and field
  team member
• Ability to support and manage difficult situations while remaining calm and working with
  team members to organize a resolution
• Ability to take direction and learn from experience and engagement with each patient
  encounter
• Ability to organize workload while supporting disruptions and escalation
• Ability be patient and caring for peers and patients

Other Skills & Competencies:

• Working knowledge of medical terminology
• Ability to perform referral related work and tasks in an organized fashion with focus on
  complete information and time related deadlines
• Ability to complete multiple projects with time sensitive deadlines
• Ability to manage more than one priority project at a time
• Ability to work as part of a team/committee to complete assigned tasks
• Ability to exercise independent judgment and at times, work independently
• Ability to enlist cooperation of other people and department in completing assigned work and
  projects
• Ability to actively communicate, inspire and motivate peers, customers, and other
  stakeholders encountered in the referral services department
• Ability to think and act strategically and proactively
• Ability to maintain accurate records and prepare reports and correspondence related to the
  work

Communication & Technical Skills

• Oral Communication - Speaks clearly and persuasively in positive or negative situations;
  listens and gets clarification; Responds well to questions; demonstrates group presentation
  skills; actively participates in meetings
• Written Communication - Writes clearly and informatively with professional context and
  direction; edits work for spelling and grammar; varies writing style to meet needs of
  audience; presents qualitative and quantitative data effectively; able to read and interpret
  written information effectively.
• Become and remain proficient is all technology platforms, applications, and programs
  necessary to perform duties

PHYSICAL DEMANDS AND WORK ENVIRONMENT

• This position requires constant sitting with occasional walking, standing, kneeling or stooping.
• This position requires the use of hands to finger, handle or feel objects and the ability to reach
  with hands and arms.
• This position requires constant talking and hearing.
• Specific vision abilities required by this job include close vision and the ability to adjust focus.
• This position must occasionally lift and/or move up to 20 pounds.
• Required to move/lift physical hardware.

AMERICANS WITH DISABILITY SPECIFICATIONS
PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee
to successfully perform the essential functions of this job. Reasonable accommodations may be made
to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use
hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs;
balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally
lift and/or move up to 20 pounds. Specific vision abilities required by the job include close vision,
distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

OTHER

• Will participate in legal and ethical compliance training each year.
• Will consistently behave in compliance with the BioMatrix, LLC’s legal and ethical policies and
  procedures.
• Will abide by the policies of BioMatrix, LLC as set forth in the Compliance Manual.
• Will not participate in any conduct considered to be unethical or illegal.

EXPECTATION FOR ALL EMPLOYEES
Supports the organization's mission, vision, and values by exhibiting the following behaviors: integrity,
dedication, compassion, enrichment and enthusiasm.

GENERAL INFORMATION:
The above statements are intended to describe the general nature and level of work being performed
by individuals assigned to this position. They are not intended to be an exhaustive list of all duties,
responsibilities, and skills required of personnel so classified.

The incumbent must be able to work in a fast-paced environment with demonstrated ability to juggle
and prioritize multiple, competing tasks and demands and to seek supervisory assistance as
appropriate.

Incumbents within this position may be required to assist or find appropriate assistance to make
accommodations for disabled individuals in order to ensure access to the organization's services (may
include: visitors, patients, employees, or others)