What are the responsibilities and job description for the Specialty Pharmacy Liaison position at KPH Healthcare Services?
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.
Salary : $18 - $27