Job Description
Job Description
The Patient Support Specialist is responsible for maintaining on-going patient care through the support of patient outreach and prescription refill management services throughout the patient’s specialty or infusion therapy. Refill management support may include but is not limited to overseeing the intake or gathering of patient documentation, obtaining new prescriptions as needed for patients to continue therapy, communicating with doctors’ offices and patients, submitting insurance re-authorizations and assisting the pharmacy operations team on a daily basis. This position requires professional communication skills and compliance with all applicable laws and regulations, including state board of pharmacy and HIPAA.
QUALIFICATION REQUIREMENTS
- Current Pharmacy Technician registration and / or certification in good standing, as required by state Board of Pharmacy
or commitment to obtaining necessary BoP registration / certification within first 60 days of employment
Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfactionExperience with data entry, navigation of technology to support work environment, and general familiarity with medical terminologyBasic level skill in Microsoft Office (including Word, Excel, PowerPoint, etc)QUALIFICATIONS PREFERRED
High School diploma or equivalent strongly preferredPharmacy Technician certification (unless required by State Board of Pharmacy)Direct patient care and / or experience communicating with patient care settings such as healthcare practices, inpatient, outpatient, skilled nursing, and / or home care settingsMinimum of 1 year of experience in Specialty pharmacyESSENTIAL FUNCTIONS AND RESPONSIBILITIES
Patient Support Responsibilities :
Contact patients to set up prescription refills while gathering necessary data points to support refill processSubmit for insurance re-authorizations as neededObtain necessary documentation from doctors’ offices and / or patients, to include lab work, prescription refills, etc., while following all legal requirementsEnsure clinical compliance of patients by asking pre-determined questions and escalating to a pharmacist when necessaryRefer all clinical questions, situations, and responses to a pharmacistCommunicate professionally with both patients and doctor offices while following all legal requirements, to include state pharmacy regulations and HIPAAResponsible for maintaining relationships with doctor’s offices to include :Appropriate communication with offices as required and permitted by law
Communication with field-based sales representative while adhering to HIPAA requirementsCustomizing services where possible in accordance with office preferencesStay up to date with appropriate level of clinical knowledge of applicable disease statesSupport other technicians, acting as mentor and trainer when appropriateAssist pharmacy operations teams as neededPharmacy Related Competencies :
Maintain knowledge of and comply with the regulatory guidelines and standards of practice of the State Board of Pharmacy, FDA, DEA, Department of Health & Human Services, Medicare, ACHC, URAC and OSHA as applicable to pharmacy locationCommunicate with physicians, patients and insurance companies within legal limits according to state, communicating professionally at all times and complying with HIPAA regulationsTriage patient and pharmacist related questions and channel to the appropriate personSupport, upon request, production / dispensing / shipping duties in an accurate and timely manner as permitted by law and under the supervision of a pharmacistAdditional duties may be assigned by managementData Entry Responsibilities :
Process all faxes and E-script ordersManage and process all refillsInput all demographic and insurance informationVerify eligibility and specific drug coverageWork on prior authorizations and insurance over-rides as instructedRun appropriate labelsSupport refill or delivery coordination reminders using designated technologyNON-ESSENTIAL FUNCTIONS & RESPONSIBILITIES
Ability to prioritize and handle multiple tasks and projects concurrentlyMust have scheduling flexibility and be able to work overtime as neededCareful attention to detailPerforms related duties as requestedParticipates in quality assurance activities and audits as directedParticipation in membership of professional societies or organizations as deemed helpful or necessary for roleKNOWLEDEGE, SKILLS AND ABILITIES REQUIREMENTS
Customer Service Skills :
Strong phone skills, speaks clearly, supports active listening, and manages call flow effectively meeting the needs of the caller as effectively and efficiently as possibleStrong ability to build and maintain contacts and effective working relationships with internal and external customers including patients, caregivers, healthcare service providers, and field team membersAbility to support and manage difficult situations while remaining calm and working with team members to organize a resolutionAbility to take direction and learn from experience and engagement with each patient encounterAbility to organize workload while supporting disruptions and escalationAbility be patient and caring for peers and patientsOther Skills & Competencies :
Working knowledge of medical terminologyAbility to perform referral related work and tasks in an organized fashion with focus on complete information and time related deadlinesAbility to complete multiple projects with time sensitive deadlinesAbility to manage more than one priority project at a timeAbility to work as part of a team / committee to complete assigned tasksAbility to exercise independent judgment and at times, work independentlyAbility to enlist cooperation of other people and department in completing assigned work and projectsAbility to actively communicate, inspire and motivate peers, customers, and other stakeholders encountered in the referral services departmentAbility to think and act strategically and proactivelyAbility to maintain accurate records and prepare reports and correspondence related to the workCommunication & Technical Skills
Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; demonstrates group presentation skills; actively participates in meetingsWritten Communication - Writes clearly and informatively with professional context and direction; edits work for spelling and grammar; varies writing style to meet needs of audience; presents qualitative and quantitative data effectively; able to read and interpret written information effectively.Become and remain proficient is all technology platforms, applications, and programs necessary to perform dutiesPHYSICAL DEMANDS AND WORK ENVIRONMENT
This position requires constant sitting with occasional walking, standing, kneeling or stooping.This position requires the use of hands to finger, handle or feel objects and the ability to reach with hands and arms.This position requires constant talking and hearing.Specific vision abilities required by this job include close vision and the ability to adjust focus.This position must occasionally lift and / or move up to 20 pounds.Required to move / lift physical hardware.AMERICANS WITH DISABILITY SPECIFICATIONS
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and / or move up to 20 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
OTHER
Will participate in legal and ethical compliance training each year.Will consistently behave in compliance with the BioMatrix, LLC’s legal and ethical policies and procedures.Will abide by the policies of BioMatrix, LLC as set forth in the Compliance Manual.Will not participate in any conduct considered to be unethical or illegal.EXPECTATION FOR ALL EMPLOYEES
Supports the organization's mission, vision, and values by exhibiting the following behaviors : integrity, dedication, compassion, enrichment and enthusiasm.
GENERAL INFORMATION :
The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required of personnel so classified.
The incumbent must be able to work in a fast-paced environment with demonstrated ability to juggle and prioritize multiple, competing tasks and demands and to seek supervisory assistance as appropriate.
Incumbents within this position may be required to assist or find appropriate assistance to make accommodations for disabled individuals in order to ensure access to the organization's services (may include : visitors, patients, employees, or others).
