What are the responsibilities and job description for the Pharmacy Coordinator - Specialty Pharmacy position at Converge HR Solutions?
What our client is looking for
Our client seeks a Pharmacy Coordinator, also called a Care Coordinator, for their Berwyn, PA, location. They seek someone passionate about helping people get the specialized therapies they need. This critical role serves as a point of contact and manages patient communications with regular follow-ups required to coordinate the delivery of medications and any necessary check-ins while taking the medication. They work with patients as an advocate and guide and coordinate with the team through the entire care continuum.
This position will be required to be in the office 5 days a week, Monday through Friday, for the first 120 days for training purposes.
The job details
About our client
Our client is a Specialty Pharmacy dedicated to providing services to smaller patient communities. We focus on securing insurance coverage, coordinating care, and complying with therapy regimens are only a few examples. Our mission is to minimize the daily impact of living with unique disorders. After just one call, our experts begin to address everything from medication delivery and insurance reimbursement to compliance and education. Every patient receives a proactive service experience tailored to their specific needs.
Our client seeks a Pharmacy Coordinator, also called a Care Coordinator, for their Berwyn, PA, location. They seek someone passionate about helping people get the specialized therapies they need. This critical role serves as a point of contact and manages patient communications with regular follow-ups required to coordinate the delivery of medications and any necessary check-ins while taking the medication. They work with patients as an advocate and guide and coordinate with the team through the entire care continuum.
This position will be required to be in the office 5 days a week, Monday through Friday, for the first 120 days for training purposes.
The job details
- Act as a patient advocate to gain insurance coverage for prescribed therapies.
- Welcome new patients and create profiles with all the critical information in the system.
- Conduct periodic insurance verification and/or authorizations for patient coverage.
- File claims for patient prescriptions and orders.
- Complete collection activities per client program specifications.
- Provide an initial and ongoing investigation and benefit explanation to the patient.
- Obtain and maintain Prior Authorizations.
- Create patient orders and associated prescription entries for new and refilled prescriptions.
- Communicate with prescribers to request new prescriptions.
- Bill for Rx (or “prescription” might be better) drugs and administration supplies.
- Assist patients with possible financial assistance.
- Arrange all necessary documents and materials for initial and ongoing shipments.
- Coordinate all deliveries and process any patient returns.
- Obtain necessary consent forms for manufacturers or patient support organizations.
- Assist pharmacists with day-to-day tasks such as filling prescriptions and entering prescription information into the patient management system for pharmacist verification.
- Assist in preparing any ad hoc report request from clients.
- Perform other related duties as assigned or as necessary; remain flexible and adaptable in work schedules and work assignments as defined by departmental and organizational needs.
- A high school diploma or equivalent is required.
- 2 or more years of experience with medical/pharmacy insurance verification, including benefit investigation.
- A current Missouri BOP Pharmacy Technician license or the ability to get one. A nurse's license in good standing is also welcome.
- Knowledge of medical terminology required.
- Knowledge of medical/pharmacy insurance benefit language such as EOBs, deductibles, out-of-pocket, co-insurance, co-pays, etc.
- Ability to define CMS 1500s, provider numbers, CPT, HCPC’s, ICD9, NCPDP and NDC codes/numbers.
- Knowledge of Medicare and Medicaid billing.
- Patient Assistance Program knowledge a plus.
- Experience with prior authorization and SMN preparation.
- Knowledge of insurance claim appeals.
- Computer literate and proficient with Microsoft Office.
- Relentless attention to detail and the ability to be a creative self-starter and team player.
- Ability to participate in and facilitate group meetings.
- Ability to thrive in a fast-paced environment with constantly changing and competing priorities.
- Excellent analytical skills and the ability to provide solutions to complex problems.
- Ability to be highly transparent, ethical, and driven.
- Excellent written and verbal communication skills, also? interpersonal skills required.
- Willingness to work a flexible schedule to support different time zones across the country.
About our client
Our client is a Specialty Pharmacy dedicated to providing services to smaller patient communities. We focus on securing insurance coverage, coordinating care, and complying with therapy regimens are only a few examples. Our mission is to minimize the daily impact of living with unique disorders. After just one call, our experts begin to address everything from medication delivery and insurance reimbursement to compliance and education. Every patient receives a proactive service experience tailored to their specific needs.
Converge HR Solutions and our clients provide equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
