Referral Specialist

BioMatrix Specialty Pharm•Las Vegas, NV

2d•Onsite

About The Position

As a key member of the referral services team, a Referral Specialist will serve as the primary contact to a referral source (prescriber, provider, healthcare center, system, and/or practice), the patient for whom the referral is for, and the field-based sales representative associated with the referral source account. In this role, the Referral Specialist will be responsible for navigating a new prescription via a referral from a referral source through the necessary steps to determine whether it can be serviced in the BioMatrix network of pharmacies. A Referral Specialist will be aligned to a geographic territory of referral sources and corresponding field-based sales team member(s). This role will work closely with data entry, reimbursement, nurse coordination, and pharmacy operations team members supporting various stages of the referral and pharmacy management processes and will understand the referral status and next steps for each referral they are responsible for supporting. The Referral Specialist will build and maintain strong and lasting relationships with key personnel within the referral source environment using effective and timely communication ensuring their patient referrals are managed through service determination in a seamless manner.

Requirements

High school diploma or GED required
Minimum of one (1) year of experience managing patient referral and prescription activities or reimbursement services in infusion or specialty therapies required
Minimum of one (1) year 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 required
Electronic health medical record or pharmacy patient management experience
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.)

Nice To Haves

Bachelor’s degree preferred
Minimum of one (1) year of experience in supporting prescriber, healthcare setting, patient, and field facing communications related to referral or prescription services in infusion or specialty therapies preferred
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

Build relationships with assigned referral sources and associated BioMatrix field representatives through communication and coordination with key personnel responsible for pharmacy referral activities within the healthcare setting
Serve as point of contact to referral source and keep necessary referral source personnel well informed of the status of referrals sent to BioMatrix for service
Follow-up with referral source, patient, and/or caregiver to collect all required information and data sets needed to support the referral process activities (including but not limited to patient demographic, pharmacy/medical benefits, clinical history, and/or prescription details)
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 turn-around time, 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