Patient Care Coordinator

5 days ago


East Rutherford, United States PersonalRX Full time

Job TitlePersonal Care Coordinator (PCC)Reports ToPersonal Care Coordinator ManagerJob DescriptionThe Personal Care Coordinator is responsible for the following processes: Daily Schedule mid-month patient calls (post first fill)Review patient profile prior to the mid-month call to see if the patient needs any new prescriptions (i.e., no refills remaining)Conduct mid-month patient calls and update the notes as neededFollow-up with patient to collect any monies owedUpdate fill lists Call the patient's doctor to get new prescriptions and/or renewals and contact the patient to let them know the new prescription/renewal was received. Note: If the PCC has trouble contacting the doctor, then the PCC will let the patient know and ask them to contact their doctorGet to know your patients and become an integral part of their care teampdate/enter patient contact(s) and their role and relationship, type of contact, contact method and notes Obtain from the customer the drug name or Rx number of the prescription(s) that needs to be refilledEnter the appropriate information into Rx2 in order to generate labels for the new or re-filled prescriptionsAnswer the telephone and direct calls to the pharmacist (where appropriate) such as, but may not be limited to, the following:New prescriptionsMedical questionsJudgmental decisionsEnter the appropriate information into Rx2 in order to process electronic third party claims for payment by insurance companies for prescriptions. If the insurance company does not get billed electronically, then the registered pharmacy technician shall gather the necessary billing forms for paper claims to insurance companies for payment of prescriptions.Process future dated claimsResolve rejected claimsAd-HocAnswer patient questions on their medications, refer all to a Pharmacist if needed, update patient notes as neededManage patient supplied medications (keep extra medications and contact the patient if more medications are required for subsequent fills)Work with Finance and Senior Management if patient balance > $50 or more than two months oldTake patients off-service only after getting approval from senior management, enter close reason for each patient and update notesMaintain the current patient address (i.e., for snowbirds)Complete assigned monthly review of medications to determine if any in stock medications are nearing an expiration date (SOP 4.4 - Removing Expired Medications From Inventory)Set and complete tasks related to follow-ups in Rx2 to ensure the above work is completed in a timely mannerReview existing SOPs and Policy and Procedures and enhance/update as neededIdentify issues/topics that require a new policy or procedure - and share with managementOverallCommunicate with team members about any issues that require input from others (e.g., pharmacists, pharmacy technicians, billing and insurance specialists)Learn company policies and procedures, and adhere to themFollow all laws and regulations concerning patient privacy and every aspect of HIPAA (Health Insurance Portability and Accountability Act)Identify issues that require a new Standard Operating Procedure (SOP) or Policy and Procedure and share with managementAnswer the phone in a timely mannerEnthusiastically participate in company meetings Supervisory ResponsibilitiesNoneQualificationsLicensureComputer SkillsLanguage SKillsOngoing Education ReqsIndividual must not be on the government exclusion lists as determined by the Office of the Inspector General (OIG) and System for Award Management (SAM)Education - College (preferred)Pharmacy technician license (required)Computer proficiencyExempt/Non-ExemptExempt (not available for overtime)Key Metrics# patients managed% patient retentionpatient satisfaction# referrals



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