Pharmacy Care Coordinator

Summary

Job Description:

• Completes benefit investigations to verify patient eligibility for prescribed specialty medications.
• Assesses requirements for authorization of medications and maintain knowledge of payer formularies and reimbursement.
• Supports third party prior authorization process and obtain appropriate overrides for new patients.
• Maintains accurate insurance information and monitor for prior authorization renewal needs to avoid gaps in medication therapy.
• Identifies financial assistance options to maximize copay savings and increase therapy adherence.
• Serves as a liaison with physicians, nurse practitioners, physician assistants, pharmacists, nurses, and social workers to provide administrative support and communicate changes in medication-related coverage.
• Utilizes the Electronic Health Record (HER) to maintain communication between departments and ensure accurate documentation in patient electronic charts.
• Performs phone functions professionally and in a timely manner, including answering phones, returning calls, and checking voice mail.
• Coordinates patient scheduling for initial and follow-up appointments.
• Triages patient clinical questions and third-party insurance denials to the pharmacist for intervention as appropriate.
• Facilitates adherence to medications by coordinating face-to-face or telephonic patient outreach for timely refills.
• Maintains a record of activities to support data collection, analysis, and ongoing reporting to leadership related to patient metrics and financial performance.
• Acts as a contact person for all non-clinical patient/customer questions.

Minimum Qualifications

• High school diploma or equivalent.
• Current or eligible for Kentucky pharmacy technician registration (if not already registered with KY Board of Pharmacy, registration requires only an application and fee).
• National Pharmacy Technician Certification preferred.
• 2+ years pharmacy technician experience preferred.
• Prior experience with third party billing, financial counseling, or medical terminology and coding preferred.
• Prior experience with Epic EMR preferred.
• Intermediate knowledge of computer systems and software, including Microsoft Excel and Microsoft Word preferred.
• Demonstrated ability to collaborate with healthcare providers and patients to communicate effectively as a patient advocate preferred.

Benefits

• Tuition Assistance reimbursement program
• Paid Time Off available for use upon hire
• Company paid Maternity and Paternity Leave
• Bereavement Leave (includes pets)
• Employee Assistance Program
• Retirement plans with company match
• Company paid Basic Life Insurance & Long-Term Disability
• Health Insurance, Pharmacy, Dental, Vision and much more!

Work Experience

Education