Pharmacy Patient Advocate Specialist
Company: Cone Health
Location: Greensboro
Posted on: March 16, 2023
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Job Description:
Overview Under general supervision of a pharmacist, verifies
insurance eligibility, benefits, verification, prior authorization,
and researches denied services to ensure payments are processed on
a timely basis. Acts as a liaison to ensure accurate processing of
all claims. Enrolls patients in pharmacy services and ensures
patients have timely access to medication and medication refills.
Works with pharmacists to ensure appropriate medication therapy is
selected and optimized to meet the patient?s needs. Talent Pool:
Allied Health Responsibilities Performs benefits investigations on
all patients receiving selected medications. Obtains insurance
prior authorizations or pre-certifications for insured
patientsCoordinates with manufacturer assistance programs for
uninsured or underinsured patients and coordinates manufacturer
drug replacement (if applicable)Acts as a liaison between the
patient, clinics (if applicable), infusion centers (if applicable)
and pharmacy.Assists patients with copay assistance via
manufacturer programs and grant foundations.Interact with
physicians, nurses, and other health care providers in a courteous
and professional manner and display the highest level of customer
service, attentiveness, and consideration possible in all
situationsUtilize internally developed systems, commercial vendor
software (to track patient eligibility, prescriptions, patient
communications and program enrollment) and inpatient and outpatient
clinical, scheduling, and financial systems as necessary (e.g. Cone
Health Link - CHL).Work collaboratively with care team to
coordinate refill phone calls to patients and follow up on
medication delivery.Works as a patient advocate and functions as a
liaison between the patient and payer to answer reimbursement
questions and avoid insurance delays.Works collaboratively with
clinical pharmacists and care team to obtain clinical and financial
information needed for program enrollment and prior authorization
for insured and uninsured patients. Qualifications
EDUCATION:Required: High school diploma or certificate of
equivalency to include basic arithmetic, algebra, reading, and
writing as well as some basic chemistry skills (ability to identify
medications requiring specialized handling).Preferred:Associates
Degree in Pharmacy Technology; Bachelors in medical or science
field EXPERIENCE:Required: Three years of pharmacy technician work
experience or three years prior authorization and/or copay
assistance programs work experience or three years combined
pharmacy technician/prior authorization and copay assistance work
experience.
LICENSURE/CERTIFICATION/REGISTRY/LISTING:REQUIREDCertified Pharmacy
Tech (CPhT)PREFERRED:ASHP Billing & Reimbursement Certificate
Responsibilities Performs benefits investigations on all patients
receiving selected medications. Obtains insurance prior
authorizations or pre-certifications for insured patients
Coordinates with manufacturer assistance programs for uninsured or
underinsured patients and coordinates manufacturer drug replacement
(if applicable) Acts as a liaison between the patient, clinics (if
applicable), infusion centers (if applicable) and pharmacy. Assists
patients with copay assistance via manufacturer programs and grant
foundations. Interact with physicians, nurses, and other health
care providers in a courteous and professional manner and display
the highest level of customer service, attentiveness, and
consideration possible in all situations Utilize internally
developed systems, commercial vendor software (to track patient
eligibility, prescriptions, patient communications and program
enrollment) and inpatient and outpatient clinical, scheduling, and
financial systems as necessary (e.g. Cone Health Link - CHL). Work
collaboratively with care team to coordinate refill phone calls to
patients and follow up on medication delivery. Works as a patient
advocate and functions as a liaison between the patient and payer
to answer reimbursement questions and avoid insurance delays. Works
collaboratively with clinical pharmacists and care team to obtain
clinical and financial information needed for program enrollment
and prior authorization for insured and uninsured patients.
Keywords: Cone Health, Greensboro , Pharmacy Patient Advocate Specialist, Other , Greensboro, North Carolina
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