Patient Support Advocate, Internal Benefit

2 weeks ago

Cleveland, United States University Hospitals Full time
Sign on bonus: $2,500

A Brief Overview

The Patient Support Advocate is knowledgeable about pharmacy and manufacturer assistance programs, insurance coverage (limitations, requirements, eligibility, formularies, prior authorizations, benefits investigations, etc.), available community and national resources, ICD-9 codes, and determinants of financial need. They display an understanding of pharmaceutical terminology (brand, generic, dose, route, etc.). The Patient Support Advocate (PSA) will work closely with pharmacy staff, clinic staff, and clinical pharmacist specialist to obtain the appropriate clinical and financial information for available assistance programs. The PSA is also responsible for providing patients and clinicians with accurate and up to date information regarding assistance programs, insurance eligibility, government subsidies, as well as maintaining a database with accurate patient and assistance program information. The PSA will work with the UH Ventures Pharmacy Services to make refill and other routine phone calls to patients and follow up on medication delivery.

What You Will Do
  • Call Center Support
    •Answer incoming calls and respond to electronic communications
    •Assist health care providers and patients by greeting them by phone; answering questions and requests; referring inquiries to the site pharmacist(s) as needed.
    •Handle customer inquiries both telephonically and by email
    •Research required information using available resources
    •Manage and resolve customer complaints
  • Medication Assistance (Access) Support
    •Process benefits investigations, prior authorizations, pre-certifications, and copayment assistance request for prescriptions received by the UH Home Care Specialty Pharmacy.
    •Maintain current knowledge of, requirements for and ability to enroll patients in: Pharmacy Assistance Program (PAP), manufacturer, state and local medication assistance programs; disease based assistance from non-profit organizations; Medicare prescription drug benefits; Social Security Low Income Subsidy; state and federal medication subsidy programs
    •Maintain documentation of patient status for resource programs in required databases
    •Evaluate all self-pay and underinsured patients for PAP/MAP eligibility and enroll patients based on financial need
    •Work collaboratively with clinical based pharmacist to obtain clinical and financial information needed for program enrollment
    •Utilize internally developed systems, commercial vendor software (to track patient eligibility, prescriptions, patient communications and program enrollment), outpatient clinical, scheduling and financial systems as necessary
    •Interact with physicians, nurses, and other health care professionals in a courteous and professional manner
  • Display the highest level of customer service, attentiveness, and consideration possible in all situations
  • Support all new team initiatives
  • Elevate issues promptly to supervisors to promote positive outcomes for internal and external customer
Additional Responsibilities
  • Performs other duties as assigned.
  • Complies with all policies and standards.
  • For specific duties and responsibilities, refer to documentation provided by the department during orientation.
  • Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.
Qualifications:
Education
  • Bachelor's Degree (Preferred)
Work Experience
  • 1+ years Healthcare experience (Required) or
  • Registered or Certified Pharmacy Technician status will be accepted in lieu of experience. (Required)
Knowledge, Skills, & Abilities
  • Excellent organizational, analytical and problem solving skills. (Required proficiency)
  • Strong oral and written communication abilities. (Required proficiency)
  • Working knowledge of the complexities and interdependencies of Insurance Benefits, Medical Records, and pharmacy operations. (Required proficiency)
  • Strong technical skills and abilities in planning, solution structure, assessment, analysis, client relationship management. (Required proficiency)
  • Maintain organized workspace to help foster efficient operations
  • Show attention to detail, accuracy, and thoroughness in an effort to continually improve quality
  • Manage time wisely and demonstrate the ability to prioritize assigned tasks
Licenses and Certifications
  • Registered Pharmacy Technician (RPhT) (Preferred)
  • (Preferred)
Physical Demands
  • Standing Occasionally
  • Walking Occasionally
  • Sitting Constantly
  • Lifting Rarely 20 lbs
  • Carrying Rarely 20 lbs
  • Pushing Rarely 20 lbs
  • Pulling Rarely 20 lbs
  • Climbing Rarely 20 lbs
  • Balancing Rarely
  • Stooping Rarely
  • Kneeling Rarely
  • Crouching Rarely
  • Crawling Rarely
  • Reaching Rarely
  • Handling Occasionally
  • Grasping Occasionally
  • Feeling Rarely
  • Talking Constantly
  • Hearing Constantly
  • Repetitive Motions Frequently
  • Eye/Hand/Foot Coordination Frequently
Travel Requirements
  • 10%

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