Job Details

ID #15560066
State Alabama
City Dothan
Job type Full-time
Salary USD TBD TBD
Source Kroger Specialty Pharmacy
Showed 2021-06-17
Date 2021-06-17
Deadline 2021-08-16
Category Et cetera
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Patient Access Coordinator - Pharmacy Technician License Required - Mon - Fri, 8am - 5pm Shift - Great Pay & Benefits!

Alabama, Dothan, 36301 Dothan USA

Vacancy expired!

Job Description

POSITION SUMMARY

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. Demonstrate the company’s core values of respect, honesty, integrity, diversity, inclusion, and safety.

ESSENTIAL JOB FUNCTIONS

  • Communicate with patients to obtain information required to process prescriptions, refills, access benefits and apply charges against co-pay cards
  • Investigate and verify benefits for pharmacy and medical third-party claims for assigned cases
  • Obtain prior authorizations; initiate requests, track progress, and expedite responses from insurance carriers and other payers, and maintain contact with customers to keep them continuously informed
  • Review for accuracy of prescribed treatment regimen prior to submission of authorization
  • Facilitate appeals process between the patient, physician and insurance company; compose clinical appeals letters based off of specific denial reason and patient’s clinical presentation and coordinate appointment of representative document
  • Complete status check with insurance company regarding receipt/outcome of prior authorization and appeal; obtain approval information and activates copay cards based off of eligibility and specific drug prescribed
  • Track, report and escalate service issues arising from requests for authorizations, financial assistance or other issues that delay service
  • Notify patients when their prescription has been transferred and follow up with specialty pharmacy to confirm the prescription was received (in some jurisdictions)
  • Coordinate verbal transfer by a pharmacist if specialty pharmacy has no record of prescription (in some jurisdictions); confirm with patient that prescription was received from alternate specialty pharmacy
  • Complete a series of assessments mandated by either manufacturer contracts or operations and facilitates patient enrollment with manufacturer Hubs when required
  • Document case activity, communications and correspondence in computer system to ensure completeness and accuracy of patient contact records
  • Ensure that work activities are conducted in compliance with regulatory requirements and the organization’s defined standards and procedures, and in a manner that provides the best available level of service and quality
  • Perform or assist with any operations, as required to maintain workflow and to meet business needs
  • Perform other related duties as assigned
  • Must be able to perform the essential job functions of this position with or without reasonable accommodation

BEHAVIORS/SKILLS

PUTS THE CUSTOMER FIRST:

Anticipates customer needs, champions for the customer, acts with customers in mind, exceeds customers’ expectations, gains customers’ trust and respect.

COMMUNICATES EFFECTIVELY AND CANDIDLY:

Communicates clearly and directly, approachable, relates well to others, engages people and helps them understand change, provides and seeks feedback,

articulates clearly, actively listens.

ACHIEVES RESULTS THROUGH TEAMWORK:

Is open to diverse ideas, works inclusively and collaboratively, holds self and others accountable, involves others to accomplish individual and team goals.

LEADS THROUGH POSITIVE INFLUENCE:

Demonstrates strong character; builds partnerships; models a conscious balance between work and personal life; takes personal responsibility for own

development; role models leadership qualities such as motivation, inspiration, passion and trust.

COACHES AND DEVELOPS OTHERS:

Develops and cares about associates, builds effective teams, helps people be their best, values and manages diversity, provides candid and constructive

feedback.

LEADS CHANGE AND INNOVATION:

Challenges the status quo, embraces technology, puts forward creative ideas, champions and implements process improvements, gathers the ideas of others,

demonstrates good judgment about which ideas will work.

EXECUTES WITH EXCELLENCE:

Is action oriented, drives for results, sets clear expectations and milestones, reviews progress, acts decisively, solves problems, can be counted on to consistently

meet or exceed goals.

PROVIDES CLEAR AND STRATEGIC DIRECTION:

Plans and organizes well, sets a clear and simple course of action, stays focused on the most important priorities, has the ability to visualize and plan for the

future, understands the industry and marketplace.

SAFETY AWARENESS:

Identifying and correcting conditions that affect employee safety; upholding safety standards.

Qualifications

MINIMUM POSITION QUALIFICATIONS

  • High School Diploma or GED
  • 1 year of proven work experience in a healthcare or customer service industry
  • Superior telephone customer service skills
  • Strong organization skills as well as attention to detail
  • Excellent knowledge of insurance benefit investigation process and techniques
  • Demonstrated ability to manage a range of priorities and meet time commitments
  • Excellent data management software skills with demonstrated adaptability to internal systems
  • Demonstrated strength in listening, oral and written communications in English

DESIRED PREVIOUS JOB EXPERIENCE/EDUCATION

  • Any additional training in pharmacy/medical benefit access and requirements
  • Any healthcare experience with a basic understanding of clinical terms and benefits investigation
  • Any previous experience in a call center preferred where performance was measured
  • Pharmacy Technician Certification

POTENTIAL CAREER PATH FROM THIS POSITION

Lead Patient Access Coordinator

Supervisor, Patient Access

Additional Information

All your information will be kept confidential according to EEO guidelines.

Vacancy expired!

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