Patient Access Liaison (PAL)

BioMatrix Specialty Pharmacy•Garnet Valley, PA

56d•$29•Onsite

About The Position

As a key member of the Intake team, a Patient Access Liaison (PAL)- Active will be responsible for on-going monthly eligibility monitoring of Active patients. If/when change of insurance or benefits is identified, PAL- Active will work with patient, sales, and/or physician to obtain new insurance and/or supporting clinical documentation to secure authorization. PAL- Active will advise the Reimbursement Specialists of new insurance and the need for new benefits verification and prior authorization if applicable. PAL- Active will continue to be the point of contact with patients, sales, physician to provide updates as necessary and may also assist with authorization and benefits questions from patients as they arise. A PAL- Active will be aligned to specific teams and will be responsible for monitoring coverage for that set of patients. This role will work closely with data entry, reimbursement, nurse coordination, and pharmacy operations team members supporting various stages of the intake and pharmacy management processes and will understand the case status and next steps for each referral they are responsible for supporting.

Requirements

1-3 years of experience managing patient referral and prescription activities or reimbursement services in infusion or specialty therapies
1-3 years of experience providing customer service in health care setting (patients and/or providers), including meeting high quality standards for services and evaluation of customer satisfaction
Electronic health medical record or pharmacy patient management experience
High School Diploma or equivalent, Bachelors' Degree preferred
Ability to multitask in a fast-paced environment
Proficient in medical or pharmacy terminology, written or verbal
Moderate skills in Microsoft Office (including Word, Excel, PowerPoint, etc.)
Willing to travel up to 5% of the time for business purposes (when necessary to attend meetings, conferences, seminars, etc.)
Working knowledge of medical terminology
Ability to perform referral related work and tasks in an organized fashion with focus on complete information and time related deadlines
Ability to complete multiple projects with time sensitive deadlines
Ability to manage more than one priority project at a time
Ability to work as part of a team/committee to complete assigned tasks
Ability to exercise independent judgment and at times, work independently
Ability to enlist cooperation of other people and department in completing assigned work and projects
Ability to actively communicate, inspire and motivate peers, customers, and other stakeholders encountered in the referral services department
Ability to think and act strategically and proactively
Ability to maintain accurate records and prepare reports and correspondence related to the work
Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; demonstrates group presentation skills; actively participates in meetings
Written Communication - Writes clearly and informatively with professional context and direction; edits work for spelling and grammar; varies writing style to meet needs of audience; presents qualitative and quantitative data effectively; able to read and interpret written information effectively.
Become and remain proficient is all technology platforms, applications, and programs necessary to perform Patient Access Liaison (PAL)- Active duties

Nice To Haves

1-3 years of experience in supporting prescriber, healthcare setting, patient, and field facing communications related to referral or prescription services in infusion or specialty therapies
General understanding of prescription benefits, insurance/payer requirements, and verification processes
General experience working in a health care setting or services environment
General knowledge of infusion therapy process and patient needs

Responsibilities

Monitor CareTend queues for Active patients and review eligibility monthly. Ensure authorization is on file and there are no barriers to servicing a patient before Pharmacy team contacts patient to set up delivery.
If any insurance coverage issues are identified, PAL- Active will work with patient, sales representative and Physician to obtain any necessary information for further review to overcome the barrier.
Assist with PAL-Pending duties as needed for coverage or additional support
Ensure last events are accurate and cases are progressing as expected
Perform activities timely and ensure downstream teams are aware of any potential service delays
Work closely with Reimbursement Specialists and conveys outcomes of benefit investigation activities with patient when it comes to patient out of pocket costs, financial responsibility, and financial assistance options for patient support consideration
Work closely and communicate with Nurse Coordination team for those patients who intend to move forward with service and require in-home nurse care to be scheduled and organized around prescription fulfillment and shipping
Work closely and communicate with Pharmacy operations team members ensuring clinical and fulfillment resources have everything they need to successfully support the on-boarding and on-going fulfillment for a new patient referral/prescription
Produce written documentation representing all provider, patient, caregiver, and/or field team updates and communications in necessary systems of record
Understand referral process, volume, and workload metrics and goals established by leadership; use goals to effectively organize referral workload and daily activities for successful outreach and completion of referral steps needed to attain service outcomes/determination
Support use of technology and other innovative digital channels for internal and external stakeholder communication as directed by leadership; leverage professional and effective communication skills when utilizing technology for written correspondence with these stakeholders
Have strong understanding of referral and prescription management processes and available services to effectively convey status, outcomes, and next steps to team members as well as referral source, patients, and field resources as expected and needed