Patient Services Specialist

Location: Remote

Office Hours: Mirror clinic hours (Monday through Friday 8:30 am to 5 pm) in either EST, CST, or MT time zones

Required: CPhT certification

Responsibilities:

• Performs patient onboarding, benefit verification, prior authorization, financial assistance and appeals processes, as needed, on behalf of patients and their physician to facilitate the process between the doctors' office and pharmacy to triage and streamline prescription fulfillment.
• Provides above services for a health system's ambulatory pharmacy, specialty pharmacy and/or outpatient infusion center environment, as requested.
• Interacts with patients and providers to obtain insurance benefits and patient information needed to request prior authorizations so that medications and other services rendered are reimbursed by payer.
• Ensure patient-specific reimbursement related information is obtained and available for review and for tracking of replacement product, including maintenance of files and documentation for PAP application submissions.
• Obtains appropriate signatures and documentation for completed PAP applications prior to submission of the application to the respective PAP.
• Completes patient adherence activities that may include notification of upcoming refills, coordination, tracking, and confirmation of prescription delivery.
• Works within health system's electronic medical record system and other applicable systems (i.e., IndiCare) to support workflow management and to document activities (i.e., retrieve information needed to deliver services, communicate status, and document outcome).
• Provides integrated services to the health system and its component parts to increase prescription capture rate, ensure timely delivery of infusion medications to be infused in the hospital setting, improve patient outcomes and reduce readmissions.
• Resolves barriers proactively that may affect reimbursement at assigned facilities and provides detailed updates to the Patient Access Management team
• Establish business relationships with assigned clinic staff, pharmacy, and hospital contacts, keeping them informed of significant changes in site-specific recovery potential based on changes to PAPs.
• Readily assists on special projects within job scope to improve reimbursement optimization when requested by management.
• Communicates patient and provider feedback to PHS management to enhance process improvement to enhance continuity of care.
• Interfaces appropriately with assigned key account associates with information relevant to additional products and services provided by Cencora and its subsidiaries.
• Demonstrates flexibility and adapts to changes in payer, pharmacy and patient assistance program processes and requirements.
• Provides temporary coverage to support clients and patients in the event of onsite resource absences.
• Performs related duties as assigned

Education:

• Degree, technical vocational training, or equivalent combination of experience and education.
• Bachelor's degree program preferred.
• Pharmacy Technician Certification Board (PTCB) certification is required.

Work experience:

• This position requires broad training in fields such as Medical Office Administration, SocialWork, Medical Records/Billing, Benefit Verification, Patient Financial Services, Pharmacy, Nursing, or similar vocations generally obtained through completion of a 2-year Associate
• 2 years of directly related or relevant experience

Skills and knowledge:

• Ability to communicate effectively both orally and in writing.
• Strong organizational skills; attention to detail
• Ability to work quickly and accurately under time and volume constraints.
• Ability to be proactive and tenaciously seek solutions under minimum supervision to improvecustomer satisfaction.
• Demonstrated competence in Microsoft Excel and Word
• Strong analytical skills
• Strong interpersonal skills
• Familiarity with insurance/claims processing, pharmaceutical products, services, software, and drug interactions

Physical requirements:

• The physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Sedentary physical activity requiring reaching, sifting, lifting, finger dexterity, grasping, feeling, repetitive motions, talking and hearing. Visual requirement is for close vision, distance vision, peripheral vision, and ability to adjust focus. 75% or more time is spent looking directly at a computer.
• Associate is frequently required to stand, walk (or otherwise be mobile). Ability to deal with stressful situations as they
  
  

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members' ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more. For details, visit https://www.virtualfairhub.com/cencora

Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law.

The company's continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory.

Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email hrsc@cencora.com. We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned