Patient Services Specialist

This is a fully remote position, open to applicants in Florida.

📋 Description

• Conducts patient onboarding, verifies benefits, manages prior authorizations, provides financial assistance, and handles appeal processes as necessary, acting on behalf of patients and their physicians to streamline the collaboration between healthcare providers and pharmacies for efficient prescription fulfillment.

• Delivers these services within a health system's ambulatory pharmacy, specialty pharmacy, and/or outpatient infusion center, as required.

• Engages with patients and healthcare providers to gather insurance benefits and patient details essential for requesting prior authorizations, ensuring reimbursement for medications and other services provided.

• Ensures that patient-specific reimbursement information is collected, reviewed, and tracked regarding replacement products, including maintaining files and documentation for Patient Assistance Program (PAP) application submissions.

• Acquires necessary signatures and documentation for completed PAP applications before submitting them to the appropriate PAP.

• Executes patient adherence activities, which may include alerts for upcoming refills, coordination, tracking, and confirming prescription deliveries.

• Operates within the health system’s electronic medical record system and relevant applications (e.g., IndiCare™) to facilitate workflow management and document activities (e.g., retrieving necessary information, updating statuses, and recording outcomes).

• Provides integrated services to the health system and its components to enhance prescription capture rates, ensure the timely delivery of infusion medications for hospital settings, improve patient outcomes, and decrease readmission rates.

• Proactively addresses issues that may influence reimbursement at designated facilities and provides comprehensive updates to the Patient Access Management team.

• Cultivates professional relationships with assigned clinic staff, pharmacy, and hospital contacts, keeping them informed of significant changes regarding site-specific recovery potential based on alterations to PAPs.

• Willingly contributes to special projects within the scope of the position to enhance reimbursement optimization when requested by management.

• Relays patient and provider feedback to PHS management to drive process improvements and ensure continuity of care.

• Appropriately interfaces with assigned key account associates, sharing pertinent information about additional products and services offered by Cencora and its subsidiaries.

• Exhibits flexibility and adaptability to changes in payer, pharmacy, and patient assistance program processes and requirements.

• Provides temporary support coverage to assist clients and patients during onsite resource absences.

⛳️ Requirements

• Required: CPhT certification

• Degree, technical vocational training, or a suitable combination of experience and education

• Preference for a Bachelor's degree program

• This role necessitates extensive training in areas such as Medical Office Administration, Social Work, Medical Records/Billing, Benefit Verification, Patient Financial Services, Pharmacy, Nursing, or similar fields typically acquired through a 2-year Associate degree.

• 2+ years of directly relevant experience

• Ability to communicate effectively in both oral and written formats

• Strong organizational skills and keen attention to detail

• Capability to work efficiently and accurately under time constraints and high volumes

• Proactive mindset with a tenacious approach to seeking solutions independently to enhance customer satisfaction

• Proven proficiency in Microsoft Excel and Word

• Strong analytical capabilities

• Exceptional interpersonal skills

• Familiarity with insurance/claims processing, pharmaceutical products, services, software, and drug interactions.

🏝️ Benefits

• We offer competitive compensation, benefits, and resources that foster a highly inclusive culture and support our team members' ability to lead purposeful lives every day.

• Alongside traditional benefits such as medical, dental, and vision care, we provide a comprehensive array of benefits that address the physical, emotional, financial, and social dimensions of wellness.

• This includes support for working families, which may encompass backup dependent care, adoption assistance, infertility coverage, family-building support, behavioral health solutions, paid parental leave, and paid caregiver leave.

• To facilitate your personal growth, we offer a wide range of training programs, professional development resources, and opportunities to engage in mentorship programs, employee resource groups, volunteer activities, and much more.