Specialty Pharmacy Coordinator

4 weeks ago


Newport News, Virginia, United States Riverside Health System Full time
Job Summary

A Specialty Pharmacy Coordinator is responsible for managing third-party billing or patient financial assistance for patients within the Riverside Health System. This role assists with managing and processing high-dollar specialty medications and may be responsible for benefits investigation, obtaining prior authorizations, copay/foundation assistance, drug replacement services, and patient financial counseling.

Key Responsibilities
  • Timely process referrals and submit clinical supporting documentation to insurance carriers, manufacturers, or foundations to expedite prior authorization and/or patient assistance processes. Collaborate with other departments to assist in obtaining prior authorizations, patient assistance medications or financial assistance. Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed. Follows prior authorization and/or patient assistance workflows and policies/procedures.
  • Demonstrates the ability to work independently, meet deadlines, and possesses excellent time management skills. Perform tasks accurately and efficiently. Possesses excellent interpersonal, customer service, and communication skills (both written and verbal); timely responses to key stakeholders.
  • Accurate documentation of all intake referrals and/or prior authorization information in patient medical records or patient assistance tracking software in compliance with policy and procedure/workflow. Completes timely documentation within the required tracking systems and retrieves necessary documentation and maintains up-to-date knowledge of the pharmaceutical companies' patient assistance programs.
  • Proactively tracks and manages patient refills/outreach to ensure timely prescription/infusion service.
  • Proactively works on prior authorization and patient assistance enrollments that are due to expire.
  • Secure patients' demographic and medical information in compliance with organization HIPAA policies and procedures.
  • Assists management with inspections, audits, reports, and training to ensure compliance with standards and to provide quality service.
Requirements
  • Familiar with medical and pharmacy terminology.
  • Prescription drug and over-the-counter knowledge.
  • Basic math skills, including pharmaceutical calculations.
  • Basic pharmacy workflow.
  • Understanding pharmacy computer systems.
  • Ability to navigate and read electronic health records.
  • Strong written and verbal communication skills.
  • Ability to prioritize, problem solve, and multitask.
  • Excellent customer service skills.
  • Knowledge of patient assistance programs.
  • Experience with prior authorization of medications.
  • Strong organizational skills and detail-oriented.
About Riverside Health System

Riverside Health System is a leading healthcare provider in the region, dedicated to delivering high-quality patient care and services. We are committed to fostering a culture of excellence, compassion, and teamwork. If you are a motivated and detail-oriented individual with a passion for pharmacy and patient care, we encourage you to apply for this exciting opportunity.

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