Specialty Pharmacy Service Representative

Stanford Health Care•Palo Alto, PA

3d•$31 - $35•Onsite

About The Position

The Specialty Pharmacy Representative serves as a key point of contact for patients, providing support with prescription management, insurance inquiries, and medication adherence. Working under direct supervision in a fast-paced environment, this role involves handling high volumes of inbound and outbound communication, coordinating refills and deliveries, verifying benefits, and resolving claim issues. Representatives are also responsible for completing patient registration, maintaining accurate records, documenting interactions, and escalating complex matters to pharmacists or senior staff as needed.

Requirements

High school diploma or general education degree (GED)
One year minimum call center experience, or other related experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.
Experience in insurance, medical, or pharmacy environments is required.
Ability to adapt to and deal with change and ambiguity.
Ability to plan, organize, prioritize, work independently and meet deadlines.
Ability to solve problems and identify solutions.
Ability to speak and write effectively at a level appropriate for the job.
Ability to work effectively with individuals at all levels of the organization.
Ability to work in a fast-paced work environment.
Knowledge of local, state and federal regulatory requirements related to areas of functional responsibility.
Knowledge of Medical terminology and abbreviations; and disease states.
Strong interpersonal communication skills.
Knowledge of computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications.
Knowledge of Microsoft Outlook and Word.
Knowledge of inflammatory diseases, infectious disease, and/or oncology.

Responsibilities

Answer patient calls: Address questions about prescriptions, refills, insurance information, and other related topics.
Medication Management: Ensure patients remain on track with medication regimen-outbound therapy/medication adherence checkups; secures refill prescriptions.
Contacts clients to schedule deliveries, confirm address, inform them of any financial responsibility.
Troubleshooting and resolving issues: Assisting with claim rejections, verifying insurance information, and helping with program eligibility.
Data entry and record-keeping: Updating patient information, documenting calls, and maintaining records.
Escalating complex issues: Provides assistance to Pharmacists, both those in the facility and those at other locations. Identifies and communicates issues to senior level staff as appropriate.
Providing customer service: Communicates with clients as needed regarding the fulfillment of prescription refills and refers any health-related concerns to a healthcare professional when required.
Following company procedures: Adhering to established protocols and guidelines for handling calls and resolving issues.
Maintaining confidentiality: Ensuring the privacy and security of patient information.
Performs other duties and responsibilities as assigned.