Pharmacy Intake Coordinator
1 week ago
Roles and Responsibilities
- Communicate with patients to obtain information required to process prescriptions, refills, access benefits and apply charges against co-pay cards.
- Investigate and verify insurance benefits and eligibility 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 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 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 facilitate 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 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.
- Must be able to perform the essential job functions of this position with or without reasonable accommodation.
- 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.
- Report any misconduct, suspicious or unethical activities to the Compliance Officer
- Participate in surveys conducted by authorized inspection agencies.
- Participate in the pharmacy’s Performance Improvement program as requested by the Performance Improvement Coordinator
- Participate in pharmacy committees when requested.
- Participate in in-service education programs provided by the pharmacy.
- Perform other related duties as assigned by supervisor
- High School Diploma or GED
- Able to read medical charts.
- 1 year of proven work experience in a healthcare
- Previous intake experience preferred but not required.
- Superior telephone customer service skills.
- Healthcare experience with a basic understanding of clinical terms and benefits investigation preferred.
- Previous experience in a call center preferred where there is familiarity with metrics and a high level of accuracy and touches.
- 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.
- Pharmacy Technician Certification preferred but not required.
- Any additional training in pharmacy/medical benefit access and requirements, preferred but not required.
- CareTend experience preferred, but not required.
Physical Requirements
Employees in this role must meet certain physical demands to perform the essential functions effectively. Reasonable accommodations will be provided for individuals with disabilities to ensure they can perform these functions. This position involves frequent sitting and requires the ability to communicate effectively through talking and listening. Occasionally, the role requires standing, walking, and using hands to operate objects, tools, or controls. The employee may also need to reach with arms and engage in physical activities such as bending, kneeling, or crouching. Regularly, the employee must lift and move items weighing up to 20 pounds, with occasional lifting of items up to 50 pounds. Visual requirements include the ability to focus, as well as maintain peripheral vision and depth perception.
EEO Statement
We are committed to fostering a diverse and inclusive workplace. As an Equal Employment Opportunity (EEO) employer, we ensure that all employment decisions are based on merit, qualifications, and business needs. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected status. We provide a work environment free from discrimination and harassment, and we celebrate diversity by creating an inclusive environment for all employees.
-
Home Infusion Intake Coordinator Specialist
6 days ago
Orange, California, United States AmeriPharma, a Harper's Pharmacy Company Full timeJob SummaryAmeriPharma, a Harper's Pharmacy Company, is seeking a highly skilled Home Infusion Intake Coordinator to join our team. As a key member of our Specialty Care IV division, you will play a vital role in ensuring patients receive seamless and high-quality home infusion therapy services.Key ResponsibilitiesPatient Assessment: Conduct comprehensive...
-
Pharmacy Intake Coordinator
2 weeks ago
Orange, United States BMR Partners Inc. Full time $20 - $26Job DescriptionJob DescriptionDescription:Roles and ResponsibilitiesCommunicate with patients to obtain information required to process prescriptions, refills, access benefits and apply charges against co-pay cards.Investigate and verify insurance benefits and eligibility for pharmacy and medical third-party claims for assigned cases.Obtain prior...
-
Home Infusion Intake Coordinator
3 months ago
Orange, United States AmeriPharma, a Harper's Pharmacy Company Full timeJob DescriptionJob DescriptionWhy Join Us?We're a rapidly growing company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves.At AmeriPharma, you'll...
-
Home Infusion Intake Coordinator
3 months ago
Orange, United States AmeriPharma, a Harper's Pharmacy Company Full timeJob DescriptionJob DescriptionWhy Join Us?We're a rapidly growing company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity. We like people who are passionate about their roles and people who like to grow and change as the company evolves.At AmeriPharma, you'll...
-
Home Infusion Services Coordinator
7 days ago
Orange, California, United States AmeriPharma, a Harper's Pharmacy Company Full timeJob SummaryAmeriPharma, a Harper's Pharmacy Company, is seeking a highly skilled Home Infusion Intake Coordinator to join our Specialty Care IV division. As a key member of our team, you will play a vital role in ensuring patients receive seamless and high-quality home infusion therapy services.Key ResponsibilitiesPatient Assessment: Conduct comprehensive...
-
Intake Coordinator
2 months ago
Orange, United States AmeriPharma Full timeJob DescriptionJob DescriptionSalary: $24-$28 Hourly/DOEAbout AmeriPharmaAmeriPharma is a rapidly growing healthcare company where you will have the opportunity to contribute to our joint success on a daily basis. We value new ideas, creativity, and productivity. We like people who are passionate about their roles and people who like to grow and change as...
-
Clinical Pharmacist
1 month ago
Orange, United States Alura Workforce Solutions Full timePosition Clinical Pharmacist Home Infusion Specialty PharmacyDescription As a Clinical Pharmacist for our Specialty division you will have the ability to provide exceptional customer service to patients and healthcare professionals while providing leadership and guidance to supporting staff. Drive key clinical and sales initiatives, build partnerships and...
-
Manager, Pharmacy
3 days ago
Orange, United States Prospect Medical Holdings Full timeThe main responsibilities of the Pharmacy Manager include: 1) leading the pharmacy referral team to ensure compliance with federal, state, health plan and IPA guidelines; 2) providing support and engaging in initiatives and processes implemented to manage specialty pharmacy costs; 3) implementing and monitoring for value-based contracts to meet pharmacy cost...
-
Licensed Practical Nurse Intake Specialist
2 weeks ago
Orange, California, United States LHC Group Full timeOverviewThe LPN Intake Coordinator is responsible for managing and evaluating incoming referral and order communications.Key ResponsibilitiesHandles incoming calls and efficiently directs them to the appropriate Intake Team members.Communicates essential patient and referral details to the relevant Intake personnel and branches.Collects demographic and...
-
Licensed Practical Nurse Intake Specialist
2 weeks ago
Orange, California, United States LHC Group Full timeOverviewThe Licensed Practical Nurse (LPN) Intake Coordinator plays a crucial role in managing and evaluating incoming referral and order communications.Key ResponsibilitiesHandles incoming calls and effectively directs them to the appropriate Intake Team members.Communicates essential patient and referral details to the relevant Intake personnel and...
-
Licensed Practical Nurse Intake Specialist
2 weeks ago
Orange, California, United States LHC Group Full timeOverviewThe Licensed Practical Nurse (LPN) Intake Coordinator plays a crucial role in managing and assessing incoming referral and order communications.Key ResponsibilitiesHandles incoming calls and effectively directs them to the appropriate Intake Team members.Communicates essential patient and referral details to the relevant Intake personnel and...
-
Licensed Practical Nurse Intake Specialist
2 weeks ago
Orange, California, United States LHC Group Full timeOverviewThe Licensed Practical Nurse (LPN) Intake Coordinator plays a crucial role in managing and evaluating incoming referral and order communications.Key ResponsibilitiesHandles incoming calls and effectively directs them to the appropriate Intake Team members.Communicates essential patient and referral details to the relevant Intake personnel and...
-
Licensed Practical Nurse Intake Specialist
2 weeks ago
Orange, California, United States LHC Group Full timeOverviewThe Licensed Practical Nurse (LPN) Intake Coordinator plays a crucial role in managing and assessing incoming referral and order communications.Key ResponsibilitiesHandles incoming calls and effectively directs them to the appropriate Intake Team members.Communicates essential patient and referral details to the relevant Intake personnel and...
-
Manager, Pharmacy
2 days ago
Orange, United States Prospect Medical Holdings Full timeJob DescriptionThe main responsibilities of the Pharmacy Manager include: 1) leading the pharmacy referral team to ensure compliance with federal, state, health plan and IPA guidelines; 2) providing support and engaging in initiatives and processes implemented to manage specialty pharmacy costs; 3) implementing and monitoring for value-based contracts to...
-
Pharmacy Technician II
3 weeks ago
Orange, United States Murtech Full timeJob DescriptionJob DescriptionPosition: Pharmacy Technician IIILocation: Cleveland, OH (east side)Duration: 4-month contract to hireDescription: We are looking for two Pharmacy Technicians for a client location on the east side of Cleveland. You will be accountable for assisting pharmacists in the retrieval, processing, preparation and distribution of...
-
Manager, Pharmacy
5 days ago
Orange, United States Alta Hospitals Full timeThe main responsibilities of thePharmacy Managerinclude: 1) leading the pharmacy referral team to ensure compliance with federal, state, health plan and IPA guidelines; 2) providing support and engaging in initiatives and processes implemented to manage specialty pharmacy costs; 3) implementing and monitoring for value-based contracts to meet pharmacy cost...
-
Manager, Pharmacy
4 days ago
Orange, United States Alta Hospitals Full timeThe main responsibilities of the Pharmacy Manager include: 1) leading the pharmacy referral team to ensure compliance with federal, state, health plan and IPA guidelines; 2) providing support and engaging in initiatives and processes implemented to manage specialty pharmacy costs; 3) implementing and monitoring for value-based contracts to meet pharmacy cost...
-
Pharmacy Manager
3 days ago
Orange, California, United States Alta Hospitals Full timeJob SummaryAlta Hospitals is seeking a highly skilled Pharmacy Manager to lead our pharmacy referral team and ensure compliance with federal, state, and health plan guidelines. The successful candidate will have a strong background in pharmacy management, excellent leadership skills, and the ability to implement value-based contracts to meet pharmacy cost...
-
Outpatient Specialty Pharmacy Lead
2 weeks ago
Orange, California, United States University of California Full timeAbout Us UCI Health represents the clinical arm of the University of California, Irvine, and stands as the sole academic health system in Orange County. Our organization includes the UCI Medical Center, a 459-bed acute care facility, alongside several hospitals and affiliated healthcare providers within the UCI Health Community Network, serving a population...
-
Pharmacy Technician
2 weeks ago
Orange, California, United States AdeIphi MedicaI Staffing Full timeAdelphi Medical Staffing is seeking a dedicated Pharmacy Technician to provide essential services at a correctional facility in Orange County, California. The ideal candidate will work closely with the on-site registered Pharmacist to ensure the smooth and efficient operation of pharmacy services within this unique setting. Your Responsibilities: Assist...