Specialty Pharmacy Liaison

KPH Healthcare Services•Oneonta, NY

4d•$18 - $27

About The Position

Overview Job Summary: Responsible for all aspects of drafting and completing prior authorizations, entering of medication orders and customer service for patients, and working as liaison with pharmacy team and provider offices. Responsibilities Educate prospective pharmacy patients on how the specialty pharmacy serves patients and improves their overall care Resolve insurance related issues, complete benefit investigations, including prior authorizations (PAs) as an agent of the provider Review the patients need for financial assistance and secure financial assistance when needed and available Document patient information within the hospital EMR, QS1, Therigy and all proprietary tools as required Secure prescription renewals Communicate directly with patients to assist them in the awareness of their medications Identify medications requiring special storage and/or handling such as hazardous medications and/or refrigerated medication Answer, resolve and triage inbound inquiries Apply observations and recommendations to operational issues, increased productivity, quality, and customer-service standards Actively participate in process improvement initiatives. Responsible for monitoring adjudication queue(s) and facilitate prior authorization process for customers Responsible for ensuring a high level of successful prior authorizations Responsible for Appeals Requests and External Appeals Requests when necessary. Act as liaison with Clinical and Pharmacy Team in communicating with provider offices on questions regarding appropriateness of therapy, labs or other questions/concerns and provide support for prior authorization, financial assistance, and prescription fill and renewal Responsible for accurate selecting billing and shipping methods for incoming patient orders Document patient reported information into TherigySTM Responsible for accurate data entry of incoming prescriptions, if required Provides resolution to customer service issues to ensure member satisfaction Customer service coverage for incoming calls, and making outbound calls to set up customer deliveries Responsible for completing all mandatory and regulatory training programs Perform other duties as assigned Qualifications Educational Requirements: Minimum: High School Diploma or GED Preferred: Pharmacy technician or related certification Experience: Experience with Prescription Prior Authorizations required 6-12 months experience as a pharmacy technician preferred Job Skill Requirements: Broad knowledge of medications, physician orders, and pharmacy systems Familiar with Enterprise billing options and practices surrounding claim submission Strong communication skills Outstanding customer service skills Excellent organization skills Ability to multitask and prioritize Excellent computer and keyboarding skills Compensation: $18.02-27.03 per hour. The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience and education. KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state and federal regulations as it pertains to minimum wage requirements.

Requirements

High School Diploma or GED
Experience with Prescription Prior Authorizations required
Broad knowledge of medications, physician orders, and pharmacy systems
Familiar with Enterprise billing options and practices surrounding claim submission
Strong communication skills
Outstanding customer service skills
Excellent organization skills
Ability to multitask and prioritize
Excellent computer and keyboarding skills

Nice To Haves

Pharmacy technician or related certification
6-12 months experience as a pharmacy technician preferred

Responsibilities

Educate prospective pharmacy patients on how the specialty pharmacy serves patients and improves their overall care
Resolve insurance related issues, complete benefit investigations, including prior authorizations (PAs) as an agent of the provider
Review the patients need for financial assistance and secure financial assistance when needed and available
Document patient information within the hospital EMR, QS1, Therigy and all proprietary tools as required
Secure prescription renewals
Communicate directly with patients to assist them in the awareness of their medications
Identify medications requiring special storage and/or handling such as hazardous medications and/or refrigerated medication
Answer, resolve and triage inbound inquiries
Apply observations and recommendations to operational issues, increased productivity, quality, and customer-service standards
Actively participate in process improvement initiatives.
Responsible for monitoring adjudication queue(s) and facilitate prior authorization process for customers
Responsible for ensuring a high level of successful prior authorizations
Responsible for Appeals Requests and External Appeals Requests when necessary.
Act as liaison with Clinical and Pharmacy Team in communicating with provider offices on questions regarding appropriateness of therapy, labs or other questions/concerns and provide support for prior authorization, financial assistance, and prescription fill and renewal
Responsible for accurate selecting billing and shipping methods for incoming patient orders
Document patient reported information into TherigySTM
Responsible for accurate data entry of incoming prescriptions, if required
Provides resolution to customer service issues to ensure member satisfaction
Customer service coverage for incoming calls, and making outbound calls to set up customer deliveries
Responsible for completing all mandatory and regulatory training programs
Perform other duties as assigned