Patient Services Specialist

Cencora•Remote, KY

7d•Remote

About The Position

The Patient Services Specialist supports a health system’s ambulatory pharmacy, specialty pharmacy, and/or outpatient infusion center by coordinating patient onboarding, benefit verification, prior authorizations, financial assistance, appeals, and related services. The role facilitates communication between patients, providers, clinics, pharmacies, and other stakeholders to help streamline prescription fulfillment and reimbursement. The specialist works in the health system’s electronic medical record and other applicable systems to manage workflows, retrieve information, communicate status, and document outcomes. The position also supports patient adherence, prescription delivery coordination, reimbursement optimization, and continuity of care. It is remote and follows clinic hours Monday through Friday, 8:30 a.m. to 5 p.m., in either the EST, CST, or MT time zone.

Requirements

Pharmacy Technician Certification Board (PTCB) certification is required.
At least 2 years of directly related or relevant experience.
Broad training in Medical Office Administration, Social Work, Medical Records/Billing, Benefit Verification, Patient Financial Services, Pharmacy, Nursing, or a similar vocation, generally obtained through completion of a 2-year associate program.
Ability to communicate effectively orally and in writing.
Strong organizational skills and attention to detail.
Ability to work quickly and accurately under time and volume constraints.
Ability to proactively and tenaciously seek solutions under minimal supervision to improve customer satisfaction.
Demonstrated competence in Microsoft Excel and Word.
Strong analytical and interpersonal skills.
Familiarity with insurance and claims processing, pharmaceutical products and services, software, and drug interactions.

Nice To Haves

Bachelor’s degree.

Responsibilities

Perform patient onboarding, benefit verification, prior authorization, financial assistance, and appeals processes as needed on behalf of patients and their physicians.
Provide services for a health system’s ambulatory pharmacy, specialty pharmacy, and/or outpatient infusion center environment.
Interact with patients and providers to obtain insurance benefits and patient information needed to request prior authorizations.
Obtain and maintain patient-specific reimbursement information and documentation, including records for replacement product tracking and Patient Assistance Program (PAP) submissions.
Obtain appropriate signatures and documentation for completed PAP applications before submission.
Complete patient adherence activities, including refill notifications and coordination, tracking, and confirmation of prescription delivery.
Use the health system’s electronic medical record and other applicable systems, including IndiCare™, to manage workflows, retrieve information, communicate status, and document outcomes.
Provide integrated services to increase prescription capture, support timely delivery of infusion medications, improve patient outcomes, and reduce readmissions.
Proactively resolve reimbursement barriers at assigned facilities and provide detailed updates to the Patient Access Management team.
Establish business relationships with assigned clinic staff, pharmacy, and hospital contacts, and inform them of significant changes in site-specific recovery potential based on PAP changes.
Assist with special projects within the job scope to improve reimbursement optimization when requested by management.
Communicate patient and provider feedback to PHS management to support process improvement and continuity of care.
Interface appropriately with assigned key account associates regarding relevant Cencora and subsidiary products and services.
Adapt to changes in payer, pharmacy, and patient assistance program processes and requirements.
Provide temporary coverage for clients and patients when onsite resources are absent.
Perform related duties as assigned.