Patient Assistance Program (PAP) Coordinator

MC-Rx Powered by ProCare Rx • Gainesville, GA

2d • Onsite

About The Position

The Patient Assistance Program (PAP) Coordinator will be responsible for processing PAP applications, managing case reviews, and maintaining communication with various stakeholders. This role involves data entry, ensuring accuracy of documentation, and coordinating with provider offices and insurance companies to facilitate patient assistance. The coordinator will also be involved in reporting, cross-training in other reimbursement workflows, and adhering to HIPAA regulations. Additionally, the role requires assessing and resolving client issues, collaborating with team members, and potentially assisting with the training of new coordinators. The position supports ProCare Rx / ProMod Rx and requires a strong understanding of healthcare processes and regulations.

Requirements

• Strong understanding of medical terminology, insurance plans and authorization processes.
• Minimum 3 years of pharmacy or healthcare experience required.
• Working in a fast-paced environment for 3+ years is required.
• Ability to manage cases from multiple clientele programs and follow program business rules.
• Proficiency with data entry functions and Microsoft applications required.
• Ability to work independently and on a team.
• Excellent communication, problem solving and customer service skills.
• Strong organizational /interpersonal skills; attention to detail and the ability to multitask proficiently.
• Ability to use multiple PC monitors and navigate through several software systems effectively.

Nice To Haves

• Bilingual English/Spanish is a plus.
• Minimum 1 year management experience of a team of 5 or more employees, preferred not required.
• College degree preferred.
• State Pharmacy Technician registration or PTCB National Certification preferred.

Responsibilities

• Process PAP applications electronically, utilizing the pharmacy CRM software systems and secure designated email accounts.
• Process fax queues, emails, answer incoming calls and adhere to all thresholds for PAP case review and management.
• Maintain clear communication and documentation with provider offices, patients and pharmacy account managers.
• Work closely with provider office point of contact(s) to obtain updated information in order to obtain missing supporting documents that are required for PAP eligibility.
• Input accurate and clear data entry of call logs, important case notes and authorization details into CRM system.
• Verify the accuracy and quality of data entry within PAP case documentation.
• Ability to confirm whether a therapy is complete and if a PAP renewal is needed.
• Initiate and follow-up on PAP renewal requests as assigned.
• Create and complete PAP data reports as assigned by the reimbursement director.
• Cross trained in the area of Rx Prior authorizations and Rx Appeal workflows to assist fellow reimbursement team members as needed.
• Contact patient’s insurance company to verify coverage, initiate authorizations, provide clinical documentation and follow up on previously submitted authorizations.
• To safeguard, protect and always demonstrate proper handling of protected health information in accordance with all HIPAA laws and ProCare Rx policies/procedures.
• Assess, prioritize and resolve client issues using good listening and comprehension skills.
• Works cooperatively and provides coverage for responsibilities of co-workers when assigned or as the need arises.
• Assist the reimbursement director with supervising and on-going training of new and/or existing PAP coordinators.
• Demonstrate working knowledge of all facets of the role, relevant regulations & organizational and departmental policies & procedures.
• Escalate issues to management as appropriate.
• Perform other duties as assigned to support ProCare Rx / ProMod Rx.

Benefits

• Medical, Dental, Vision, Short-Term/Long-Term Disability Insurance, Life insurance.
• Paid vacation and holiday pay.
• Employee Wellness Program.
• 401 k with a company match.
• Employee Assistance Program provides confidential support and counseling.
• Employee referral program.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED