Employment Status:

Shift:

Facility:

Requisition Number:

How Youll Help Transform Healthcare:

The Specialty Pharmacy Coordinator

• Provides initial patient onboarding and account setup for specialty pharmacy services including intake of referrals therapy changes and service requests.

• Enters updates and maintains accurate patient insurance benefits and authorization data in pharmacy and care management systems.

• Communicates with patients throughout onboarding and therapy to obtain required information explain processes and provide status updates.

• Conducts insurance benefits and financial investigations to determine coverage prior authorization and reimbursement requirements.

• Completes initial and renewal prior authorization submissions and tracks approval status.

• Communicates approvals denials delays and next steps to patients providers pharmacists and internal teams.

• Identifies patient financial assistance needs and facilitates enrollment in copay manufacturer or patient assistance programs.

• Collaborates with pharmacists and providers to obtain clinical documentation and letters of medical necessity.

• Assists patients with billing questions outstanding balances and payment arrangements in accordance with established guidelines.

• Responds to incoming phone calls and electronic communications and resolves customer inquiries and concerns.

• Runs and reviews standard departmental reports to support audit compliance and revenue monitoring.

• Identifies opportunities for workflow efficiency and process improvement within assigned responsibilities.

• Maintains confidentiality and complies with regulatory accreditation and organizational requirements.

What We Require:

Education: High school diploma or equivalent required.

Experience: Minimum of 3 years of pharmacy or healthcare revenue cycle experience

Licensure Certification and/or Registration: Virginia Board of Pharmacy registration. Certified Pharmacy Technician (CPhT) required

Other Minimum Qualifications: Knowledge of government and commercial insurance specialty pharmacy workflows strong customer service problem-solving and system proficiency

This job description is only meant to be a representative summary of the major responsibilities and accountabilities performed by the incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

Recruiter:

Recruiter Email:

For more information contact the HR Service Center at 1-.

Carilion Clinic is an Equal Opportunity Employer: We provide equal employment opportunities to all employees and applicants without regard to race color religion sex national origin age (40 or older) disability genetic information or veterans status. Carilion is a Drug-Free Workplace. For more information or for individuals with disabilities needing special assistance with our online application process contact Carilion HR Service Center at 8:00 a.m. to 4:30 p.m. Monday through Friday.

For more information on E-Verify: Pay and Well-beingat Carilion Clinic

Carilion understands the importance of prioritizing your well-being to help you develop and thrive. Thats why we offer a well-rounded benefits package and many perks and well-being resources to help you live a happy healthy life at work and when youre away.

When you make your tomorrow with us well enhance your potential to realize the best in are benefits available to you when you join Carilion:

• Comprehensive Medical Dental & Vision Benefits
• Employer Funded Pension Plan vested after five years (Voluntary 403B)
• Paid Time Off (accrued from day one)
• Onsite fitness studios and discounts to our Carilion Wellness centers
• Access to our health and wellness app Virgin Pulse
• Discounts on childcare
• Continued education and training