Pharmacy Patient Care Coordinator
About The Position
The Pharmacy Patient Care Coordinator serves, under the supervision of the Pharmacist in Charge, as the primary point of contact between PIHC Pharmacy and an assigned PIHC Clinic Team. The role provides professional customer service and communication regarding patient access to medication services, including benefits investigations, prior authorizations, appeals, copay assistance, refills, and other parts of the patient medication journey. The coordinator supports medication access and continuity of treatment by coordinating assistance programs and documentation, addressing billing and claims issues, and helping patients and prescribers navigate prior authorizations. The role also supports medication compliance, contributes to process improvements, and provides service in accordance with pharmacy policies, HIPAA requirements, and applicable state and federal laws. Additional job-related responsibilities or quality-improvement projects may be assigned based on departmental needs.
Requirements
- Licensed pharmacy technician in good standing with the Georgia Board of Pharmacy.
- Two to four years of pharmacy technician experience in a retail setting, including experience with pharmacy insurance navigation and medication-assistance programs.
- Ability to work independently without close supervision when appropriate.
- Ability to adapt to changes in workflow or style.
- Proficiency with computers, word processing, documentation, and internet navigation.
- Excellent time-management and research skills.
- Ability to problem-solve and communicate effectively.
- Knowledge of Patient Assistance Programs (PAPs) and ability to navigate alternative sources of funding.
- Strong dedication to patient care and improving medication access.
- Understanding of and ability to comply with Georgia Board of Pharmacy rules and regulations.
- High attention to detail.
- Comfort addressing insurance rejections and processing prescription claims.
- Self-motivated and driven to succeed.
Nice To Haves
- Bilingual in English and Spanish.
- Experience working in HIV and/or specialty pharmacy.
- Experience working in a 340B pharmacy and/or 340B contract pharmacy.
- Previous experience with Cerner EMR.
- Past experience with Pioneer Rx Fill Software.
Responsibilities
- Serve as the PIHC Pharmacy liaison to an assigned clinic team and respond to medication-access questions from patients, providers, and others involved in care.
- Act as a primary internal and external liaison and subject matter resource for medication assistance, including through educational trainings.
- Screen, apply for, and coordinate medication-assistance opportunities for patients.
- Coordinate paperwork and enrollment for manufacturer and disease-based assistance programs; identify copay assistance for underinsured patients and use charity funds when appropriate, following pharmacy policies and procedures.
- Assist patients and prescribers with the prior authorization process.
- Coordinate billing and obtain cost approval.
- Troubleshoot rejected claims, investigate eligibility and claim status, work with processors on billing issues or retroactive billing, and help expedite claims processing.
- Identify problematic third-party-payer scenarios proactively and report billing or reimbursement trends and issues.
- Support agency-wide efforts to ensure access to prescription medications.
- Coordinate documentation to support treatment continuity, improve medication access, reduce financial strain, and answer medication-assistance questions.
- Support the medication compliance program by contacting patients as needed, confirming refill needs, and keeping patient information accurate and current.
- Contribute to policy changes, goal setting, and recommendations for improvement.
- Attend and conduct meetings as appropriate by pharmacy management.
- Provide quality customer service to patients and healthcare providers while maintaining professional discretion and complying with HIPAA regulations.
- Perform tasks safely and consistently with corporate policies and state and federal laws.
- Take on additional process or quality-improvement projects as assigned based on departmental need.
Benefits
- Health Wellness day per quarter.
- Parental leave.
- Free parking at locations and bus-line accessibility.
- Competitive salary and benefits.
- Automatic 3% Safe Harbor and 2% profit sharing through the retirement program.
- 100% allotted for employee benefit elections and 50% allotted for spouse/dependent benefit elections.
- Credit union.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
