Drug Coordinator

Retina Consultants of Texas•Houston, TX

About The Position

Retina Consultants of Texas (RCTX) is seeking a Drug Coordinator to advocate for patients and help ensure their prescribed drug therapy and pharmacy care plans are followed. The role coordinates resources for patients who need copay assistance, supports successful drug therapy outcomes, resolves patient inquiries promptly, and builds and maintains strong relationships with physicians and patients throughout the process. The candidate must be able to support variable hours Monday through Friday, between 8:00 a.m. and 5:30 p.m. RCTX is a retina-only ophthalmology practice serving two major metropolitan markets and their extensions, with 26 physicians and 25 locations. The organization emphasizes its core values of Hard Work, Authentic Care, and Innovation, and invests in its people and diagnostic equipment. Full-time eligible employees receive benefits after a 60-day introductory period. The stated pay rate is $20.00 or more per hour, with eligibility for overtime.

Requirements

High school diploma or equivalent.
Four to six years of experience in the insurance, biotechnology, or pharmaceutical industries; customer service and/or reimbursement experience preferred.
Proficiency with MS Office applications.
Excellent written and verbal communication skills and the ability to communicate with people at all levels.
Ability to manage multiple priorities in a fast-paced environment and meet deadlines.
Organized, detail-oriented, and analytical.
Ability to support variable hours Monday through Friday, 8:00 a.m. to 5:30 p.m.

Nice To Haves

Bachelor's degree.
Electronic Health Records or Practice Management experience.
Knowledge of third-party billing, coding, medical terminology, prior authorizations, and appeals.
Health insurance claims or patient accounting experience.

Responsibilities

Conduct benefit investigations, verify patient insurance benefits, submit and obtain prior authorizations as required by payers, and obtain recertification when treatment or coverage extends beyond the original approval.
Review, obtain, enter, and maintain copay assistance data in the client database and patient files; monitor outstanding items to ensure tasks are complete and determine current status.
Participate in conference calls as needed with drug vendor representatives regarding drug orders and the status of alternative funding.
Coordinate product orders and shipments and therapy initiation with the pharmacy and patient.
Participate in call center activities by triaging and responding to incoming calls from patients, insurance companies, physicians, vendor representatives, and pharmacies; may serve as the single point of contact for an assigned group of prescribers.
Identify and report events according to Revenue Cycle Manager requirements for specified medications; recognize adverse events, product quality complaints, and potential risk events, and forward information to the appropriate team member for manufacturer reporting.
Educate patients, prescribers, and others about program requirements and facilitate referrals.
Maintain good housekeeping practices, adhere to quality and production standards, and comply with applicable company, state, and federal safety and environmental programs and procedures.