Specialty Pharmacy Patient Care Coordinator
3 weeks ago
Overview
Job Summary:
The Specialty Pharmacy Patient Care Coordinator is responsible for receiving and/or processing prescriptions specifically related to specialty medications for various disease states, addressing and resolving rejected claims, conducting and completing necessary third party (insurance) specialty prior authorization requests. Performs duties of in coordinating and managing all aspects related to insurance benefit information, authorization and billing. Interacts with pharmacists, medical/clinical staff, fiscal personnel, department managers, access services staff, coding staff, billing assistants, interdisciplinary caregivers, and patients. Maintains a general knowledge of all the disease categories adopted by Specialty Pharmacy Management. May also contribute to research, projects and publications.
Key Essential Functions:
- Works with patients, family, and caregivers to help mitigate financial burden.
- Effectively communicates with provider regarding any issues that include, but are not limited to, pharmacy claims, insurance verification, benefits coordination, and copay cost/support.
- Verifies and monitors insurance coverage. Ensures that all payors are active and approvals are current before medications are processed and shipped.
- Specialty billing knowledge and accurate processing, including Medicare B benefits and coordination.
- Communicates with payor and/or pharmacy representatives to resolve approval, processing, shipping, and/or copay assistance issues.
- Answers and triages telephone calls. Receives information and refers calls to appropriate pharmacy personnel.
- Maintains an understanding of collaborative pharmacy sites/teams' functions, protocols, and communication requirements.
- Demonstrates working knowledge of EHR, Dispensing Software, Patient Management Software.
Additional Essential Functions:
- Assists the pharmacist and other technicians in preparing and processing medication orders/prescriptions.
- Assumes responsibility for inventory maintenance to ensure that quality in-date drug products and supplies are available when needed.
- Receives and enters payments while following PCI compliance regulations, as applicable.
- Proactively tracks and resolves shipping grievances and concerns.
- Reads departmental communications in a timely manner.
- Completes assigned learning modules within time requirements.
- Participates in quality assurance and performance improvement activities when requested.
- Maintains knowledge of specialty medication REMs programs and ensures prescriptions are processed within applicable guidelines.
- Follows all processes and procedures for proper management of controlled substances.
- Contributes to and participates in activities and policy/procedures related to specialty pharmacy accreditation.
- Learns and maintains knowledge of disease specific medications, which includes an understanding of specific manufacturer hub services programs and both internal and external access to specialty medications.
- Completes prior authorizations for prescription plans or pre certifications for medical coverage, as applicable.
- Contributes to specialty pharmacy, clinical, or other research projects and publications.
- Demonstrates flexibility and responsiveness to scheduling and time management needs.
Education, Experience and Certifications
High school diploma or a state high school equivalency certificate (GED) required.
Registration with state board of pharmacy per state of employment requirements within 30 days of hire.
Certification through Pharmacy Technician Certification Board (CPhT) or National Healthcareer Association (ExCPT) within 6 months of hire.
Associates degree preferred.
Three years pharmacy experience and two years call center or customer service experience highly preferred.
Retail pharmacy or healthcare/medical group experience and two years of healthcare related billing preferred.
Preferred experience of specialty clinical management process.
Experience working with providers and staff to complete medication prior authorizations and secure medication funding is preferred. Microsoft Office experience preferred. Membership in a valid professional technician organization such as NCAP, AAPT, etc. is encouraged, with evidence of active involvement preferred.
#Indeed456
-
Pharmacy Relationship Manager
3 weeks ago
Macon, United States America's Pharmacy Group, LLC Full timeWhether you are working in a Pharmacy looking for additional income, an established healthcare sales professional, or looking to break into Medical Sales, Healthcare Marketing Group, LLC is a great opportunity for you. As a Pharmacy Relationship Manager, you will help drive the growth of our company through building and retaining customer relationships. You...
-
Clinical Pharmacy Manager
4 weeks ago
Macon, United States Atrium Health Full timeJob Summary: The Clinical Pharmacy Manager plans, directs, organizes, and controls systems and resources of a specified pharmaceutical service area. The pharmacy manager ensures services meet clinical, financial and customer satisfaction goals. Essential functions: Manages specific area of pharmaceutical service delivery including but not limited to AHC,...
-
Clinical Pharmacy Manager
4 weeks ago
Macon, United States Atrium Health Full timeOverview Job Summary: The Clinical Pharmacy Manager plans, directs, organizes, and controls systems and resources of a specified pharmaceutical service area. The pharmacy manager ensures services meet clinical, financial and customer satisfaction goals. Essential functions: Manages specific area of pharmaceutical service delivery including but not limited...
-
Clinical Pharmacy Manager
4 weeks ago
Macon, United States Atrium Health Full timeOverview Job Summary: The Clinical Pharmacy Manager plans, directs, organizes, and controls systems and resources of a specified pharmaceutical service area. The pharmacy manager ensures services meet clinical, financial and customer satisfaction goals. Essential functions: Manages specific area of pharmaceutical service delivery including but not...
-
Unit Secretary
3 weeks ago
Macon, United States Piedmont Urgent Care by Wellstreet Full timeJob DescriptionJob DescriptionROLE AND RESPONSIBILITIES• Offers and fills appropriate medications accurately in house as prescribed by physician. • Accepting payments for medications, in-house services for self-pay patients, or other balances that have been determined. • Regularly keeps track of medication stock and keeps clinic stocked with...
-
Full-Time Retail Pharmacy Manager
2 weeks ago
Macon, United States PharmD on Demand Full timeJob DescriptionJob DescriptionSalary: Full-Time Retail Pharmacy Manager Position Available at First Choice Primary Care in Macon, GA. (Located within the clinic at First Choice Primary Care.)Schedule: 8am to 6pm (4 days per week, 10 hour shifts). Monday-Thursday and some weekends when needed. Benefits Eligible (Insurance Options, PTO, 401(k) with...
-
Full-Time Retail Pharmacy Manager
1 month ago
Macon, United States PharmD on Demand Full timeJob DescriptionJob DescriptionSalary: Full-Time Retail Pharmacy Manager Position Available at First Choice Primary Care in Macon, GA. (Located within the clinic at First Choice Primary Care.)Schedule: 8am to 6pm (4 days per week, 10 hour shifts). Monday-Thursday and some weekends when needed. Benefits Eligible (Insurance Options, PTO, 401(k) with...
-
Pharmacy Manager
3 weeks ago
Macon, United States Kroger Full timeJoin Kroger, where People Matter. We are a reliable brand that offers a better work life balance and properly staffed technician support. With more trained technicians than our competitors, you will have the support system in place that allows you more autonomy and the ability to enhance patient outcomes.Position SummaryAccountable for all aspects of...
-
Pharmacy Manager
3 weeks ago
Macon, United States Kroger Full timeJoin Kroger, where People Matter. We are a reliable brand that offers a better work life balance and properly staffed technician support. With more trained technicians than our competitors, you will have the support system in place that allows you more autonomy and the ability to enhance patient outcomes.Position SummaryAccountable for all aspects of...
-
Patient Service Representative
3 weeks ago
Macon, United States WellStreet Urgent Care Full timeScheduling is tentative 8am - 8pm, 3 shifts/week for full time on a floating schedule. Rotatingweekends andholidays are required.Job description The Patient Service Representative is the first point of contact between the patient and clinical staff. Patient check in, insurance verification, collection of co-pays and balances, various other front office...
-
Patient Service Representative
2 weeks ago
Macon, United States WellStreet Urgent Care Full timeScheduling is tentative 8am - 8pm, 3 shifts/week for full time on a floating schedule. Rotatingweekends andholidays are required.Job description The Patient Service Representative is the first point of contact between the patient and clinical staff. Patient check in, insurance verification, collection of co-pays and balances, various other front office...
-
Patient Service Representative
3 weeks ago
Macon, United States Piedmont Urgent Care Defunct Full timeScheduling is tentative 8am - 8pm, 3 shifts/week for full time on a floating schedule. Rotating weekends and holidays are required. Job description The Patient Service Representative is the first point of contact between the patient and clinical staff. Patient check in, insurance verification, collection of co-pays and balances, various other front office...
-
Patient Service Representative
2 weeks ago
Macon, United States Piedmont Urgent Care Defunct Full timeScheduling is tentative 8am - 8pm, 3 shifts/week for full time on a floating schedule. Rotating weekends and holidays are required. Job description The Patient Service Representative is the first point of contact between the patient and clinical staff. Patient check in, insurance verification, collection of co-pays and balances, various other front office...
-
Pharmacy Technician II
4 weeks ago
Macon, United States Atrium Health Full timeOverview Job Summary: Under the supervision of a pharmacist, performs advanced technical activities including preparation of sterile products, narcotic control, outpatient pharmacy operations, unit based drug modules (Pyxis/Diebold) inventory management or drug order receiving and inventory management. Performs two or more of the following functions. Works...
-
Pharmacy Technician II
4 weeks ago
Macon, United States Atrium Health Full timeOverview Job Summary: Under the supervision of a pharmacist, performs advanced technical activities including preparation of sterile products, narcotic control, outpatient pharmacy operations, unit based drug modules (Pyxis/Diebold) inventory management or drug order receiving and inventory management. Performs two or more of the following functions. ...
-
Pharmacy Technician II
2 weeks ago
Macon, United States Atrium Health Full timeOverview Job Summary: Under the supervision of a pharmacist, performs advanced technical activities including preparation of sterile products, narcotic control, outpatient pharmacy operations, unit based drug modules (Pyxis/Diebold) inventory management or drug order receiving and inventory management. Performs two or more of the following functions. Works...
-
Patient Service Representative
3 weeks ago
Macon, United States Piedmont Urgent Care by Wellstreet Full timeJob DescriptionJob DescriptionScheduling is tentative 8am - 8pm, 3 shifts/week for full time on a floating schedule. Rotating weekends and holidays are required. Job descriptionThe Patient Service Representative is the first point of contact between the patient and clinical staff. Patient check in, insurance verification, collection of co-pays and balances,...
-
Patient Service Representative
2 weeks ago
Macon, United States Piedmont Urgent Care by Wellstreet Full timeJob DescriptionJob DescriptionScheduling is tentative 8am - 8pm, 3 shifts/week for full time on a floating schedule. Rotating weekends and holidays are required. Job descriptionThe Patient Service Representative is the first point of contact between the patient and clinical staff. Patient check in, insurance verification, collection of co-pays and balances,...
-
Purchasing Coordinator
2 weeks ago
Macon, United States Pharmscript Full timeOverview: PharmScript is one of the nations leading pharmacies, partnering with long-term and post- acute care facilities to supply medications to thousands of residents and patients. When you join the PharmScript family, you join the ranks of more than 2,000 dedicated people across the country who help to get safe, accurate, and timely medication to those...
-
Travel Registered Nurse
2 weeks ago
Macon, United States Specialty Medical Staffing Full timeRegistered Nurse (RN) Long Term Acute Care RN (LTAC) - NightsSpecialty Medical Staffing, Inc. is looking to hire night Shift Registered Nurse (RN) Long Term Acute Care RN (LTAC) for full-time travel contract opportunities in Macon, GA. Our ideal candidates will have 1.5+ years of previous bedside experience, preferably in the Long-Term Acute Care (LTAC)...