drjobs Patient Services Specialist

Patient Services Specialist

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Job Location drjobs

Knoxville, TN - USA

Monthly Salary drjobs

Not Disclosed

drjobs

Salary Not Disclosed

Vacancy

1 Vacancy

Job Description

Our team members are at the heart of everything we do. At Cencora we are united in our responsibility to create healthier futures and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health come join our innovative company and help us improve the lives of people and animals everywhere. Apply today!

Job Details

The Patient Services Specialist is responsible for initiating researching completing submitting and tracking Patient Services Program applications for assigned facilities. The incumbent is responsible for conducting benefit verification and completing necessary third-party prior authorizations reimbursement activities patient assistance and copay program enrollments. They may also coordinate refill calls perform documented adherence activities and coordinate dispensing for specialty medications high-cost prescriptions and/or infusion medications. This role requires proactive interaction with facility staff patients payers and patient assistance programs (PAP). Occasional travel may be required.

Location: Onsite Knoxville TN

Responsibilities:

  • Performs patient onboarding benefit verification prior authorization and appeals processes as needed on behalf of patients and their physician to facilitate the process between the doctors office and pharmacy to triage and streamline prescription fulfillment.

  • Provides above services for a health systems ambulatory pharmacy specialty pharmacy and/or outpatient infusion center environment as requested.

  • Interacts with patients and providers to obtain insurance benefits and patient information needed to request prior authorizations so that medications and other services rendered are reimbursed by payer.

  • Ensures that patient-specific reimbursement related information is obtained and available for review and for tracking of replacement product including maintenance of files and documentation for PAP application submissions.

  • Obtains appropriate signatures and documentation for completed PAP applications prior to submission of the application to the respective PAP.

  • Completes patient adherence activities that may include notification of upcoming refills coordination tracking and confirmation of prescription delivery.

  • Works within health systems electronic medical record system and other applicable systems (i.e. IndiCare) to support workflow management and to document activities (i.e. retrieve information needed to deliver services communicate status and document outcome).

  • Provides integrated services to the health system and its component parts to increase prescription capture rate improve patient outcomes and reduce readmissions.

  • Resolves barriers proactively that may affect reimbursement at assigned facilities and provides detailed updates to the Patient Assistance Services Management when unable to resolve independently.

  • Establish business relationships with assigned clinic staff pharmacy and hospital contacts keeping them informed of significant changes in site-specific recovery potential based on changes to PAPs.

  • Readily assists on special projects within job scope to improve reimbursement optimization when requested by management.

  • Communicates patient and provider feedback to PHS management to enhance process improvement to enhance continuity of care.

  • Interfaces appropriately with assigned key account associates with information relevant to additional products and services provided by Cencora and its subsidiaries.

  • Demonstrates flexibility and adapts to changes in payer pharmacy and patient assistance program processes and requirements.

  • Provides temporary coverage to support clients and patients in the event of onsite resource absences.

  • Performs related duties as assigned.

Education:

  • This position requires broad training in fields such as Medical Office Administration Social Work Medical Records/Billing Benefit Verification Patient Financial Services Pharmacy Nursing or similar vocations generally obtained through completion of a 2-year Associate Degree technical vocational training or equivalent combination of experience and education. Bachelors degree program preferred.

  • Pharmacy Technician Certification Board (PTCB) or Certified Medical Assistant (CMA) or state certification may be required contingent on client requirements.

Skills and Knowledge:

  • Ability to communicate effectively both orally and in writing.

  • Strong organizational skills; attention to detail

  • Ability to work quickly and accurately under time and volume constraints.

  • Ability to be proactive and tenaciously seek solutions under minimum supervision to improve customer satisfaction.

  • Demonstrated competence in Microsoft Excel and Word

  • Strong analytical skills

  • Strong interpersonal skills

  • Familiarity with insurance/claims processing pharmaceutical products services software and drug interactions

What Cencora offers

We provide compensation benefits and resources that enable a highly inclusive culture and support our team members ability to live with purpose every day. In addition to traditional offerings like medical dental and vision care we also provide a comprehensive suite of benefits that focus on the physical emotional financial and social aspects of wellness. This encompasses support for working families which may include backup dependent care adoption assistance infertility coverage family building support behavioral health solutions paid parental leave and paid caregiver leave. To encourage your personal growth we also offer a variety of training programs professional development resources and opportunities to participate in mentorship programs employee resource groups volunteer activities and much more. For details visit time

Equal Employment Opportunity

Cencora is committed to providing equal employment opportunity without regard to race color religion sex sexual orientation gender identity genetic information national origin age disability veteran status or membership in any other class protected by federal state or local law.

The companys continued success depends on the full and effective utilization of qualified individuals. Therefore harassment is prohibited and all matters related to recruiting training compensation benefits promotions and transfers comply with equal opportunity principles and are non-discriminatory.

Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment please call 888.692.2272 or email . We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned

Affiliated Companies

Affiliated Companies: Value Apothecaries Inc

Required Experience:

Unclear Seniority

Employment Type

Full-Time

About Company

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