Pharmacy Patient Advocate

CareTria•,

4d•Hybrid

About The Position

The Pharmacy Patient Advocate supports the enrollment process and patients in accessing coverage for their prescribed medications through inbound and outbound telephone support, as well as administrative functions. This role involves reviewing and processing enrollment forms, assisting patients with program enrollment, verifying pre-screening and qualifying tasks, and communicating with patients and healthcare providers regarding approvals, denials, and next steps. The advocate also schedules treatments, handles inbound and outbound calls for the Patient Assistance Program (PAP), and communicates daily with patients and healthcare providers to manage expectations and gather necessary information for enrollment. Additionally, they explain the PAP program and services, respond to inquiries, report adverse events, execute daily operations, and maintain patient confidentiality.

Requirements

High school diploma or equivalent
Kentucky Pharmacy Technician Registration
Must be over the age of 18 (as required by Kentucky for licensed pharmacy technicians)
Two (2) years of work experience in customer service or customer focused healthcare role
One (1) year of work experience in a HUB service or call center environment.
Strong attention to detail and accuracy in data entry
Experience with insurance and benefit investigations; knowledge of U.S. Private and Government payers
Must have proven ability to provide consistently high-quality of service
Demonstrated empathy and compassion
Excellent verbal and written communication skills
Excellent organization skills and detail oriented
Balance multiple priorities to meet expected response deadlines
Adaptable, flexible and readily adjust to changing situations
Ability to work independently and as a member of a team
Ability to comprehend and apply basic math principles
Ability to apply logical thinking when evaluating practical problems
Ability to present information and respond to questions from stakeholders
Ability to interact with a diverse group
Ability to listen and demonstrate a high degree of empathy
Demonstrated computer skills includes Microsoft Word, Excel, and Outlook
Display tact and diplomacy in response to unfavorable or negative situations
Demonstrated sensitivity and understanding when speaking with patients
Demonstrated passion for speaking with people in an outgoing way

Nice To Haves

Associate degree or completion of technical school training in healthcare, pharmacy or a related field
Two (2) years of work experience in pharmacy, managed care, Medicaid and/or Medicare organizations, pharmaceutical and/or biotech manufacturer, insurance, medical office, or related field
Experience with HIPAA regulations and privacy standards
National Pharmacy Certification (PTCB, ExCPT) preferred
Bilingual proficiency in English and Spanish strongly preferred
Prior experience in patient assistance programs and/or benefit verification processes

Responsibilities

Review and process patients’ enrollment forms to the Patient Assistance Program (PAP)
Assist patients on the phone with PAP program enrollment by verifying the pre-screening and qualifying tasks.
Notify patients and healthcare providers of approvals, denials, and any next steps needed to continue the enrollment process
Schedule treatments to be sent to the patient or patient’s healthcare provider
Support inbound and outbound phone lines for the PAP program
Communicate daily with patient/authorized representatives on eligibility based on PAP criteria and healthcare providers to manage expectations.
Contact patient/authorized representative to determine supplementary information needed to enroll into the manufacturer’s PAP program.
Prioritize workload to ensure patients’ enrollments are processed within specified timeframe
Explain the PAP program and services to patients, authorized representatives, healthcare providers and physician office staff.
Respond to program inquiries from patients, authorized representatives, healthcare providers, patient advocates, and caregivers.
Report adverse events/product complaint inquires received in accordance with standard operating procedures and current good manufacturer practices.
Execute day-to-day operations specific to the assigned program(s).
Always maintain patient confidentiality.