Patient Services Specialist

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

📋 Description

• Facilitates patient onboarding, benefit verification, prior authorization, financial assistance, and appeals processes on behalf of patients and their physicians to optimize the workflow between medical offices and pharmacies for efficient prescription fulfillment.

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

• Engages with patients and providers to gather insurance benefits and necessary patient information for prior authorization requests, ensuring reimbursement for medications and services rendered by payers.

• Ensures that patient-specific reimbursement information is collected and available for review, tracking replacement products, and maintaining files and documentation for Patient Assistance Program (PAP) application submissions.

• Secures appropriate signatures and documentation for completed PAP applications before submitting them to the relevant PAP.

• Conducts patient adherence activities, which may include notifying patients about upcoming refills, coordinating, tracking, and confirming prescription deliveries.

• Utilizes the health system’s electronic medical record system and other relevant systems (e.g., IndiCare™) to manage workflow and document activities (such as retrieving necessary information to deliver services, communicating status, and documenting outcomes).

• Delivers integrated services to the health system and its components to enhance prescription capture rates, ensure timely delivery of infusion medications in hospital settings, improve patient outcomes, and minimize readmissions.

• Proactively addresses barriers that may impact reimbursement at assigned facilities and provides comprehensive updates to the Patient Access Management team.

• Establishes professional relationships with assigned clinic staff, pharmacy, and hospital contacts, keeping them informed about significant changes in site-specific recovery potential due to modifications in PAPs.

• Actively participates in special projects within the job scope aimed at improving reimbursement optimization as requested by management.

• Communicates feedback from patients and providers to PHS management to foster process improvements that enhance continuity of care.

• Appropriately interacts with assigned key account associates regarding additional products and services offered by Cencora and its subsidiaries.

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

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

⛳️ Requirements

• Required: CPhT certification

• A degree, technical vocational training, or an equivalent combination of experience and education

• Preference for candidates with a Bachelor's degree

• This position 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 the completion of a 2-year Associate degree

• Minimum of 2 years of directly related or relevant experience

• Effective oral and written communication skills

• Strong organizational abilities and attention to detail

• Capacity to work efficiently and accurately under time and volume constraints

• Proactive mindset with a determination to seek solutions independently to enhance customer satisfaction

• Proven proficiency in Microsoft Excel and Word

• Strong analytical and interpersonal skills

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

🏝️ Benefits

• We offer compensation, benefits, and resources that foster a highly inclusive culture, supporting our team members in living with purpose every day.

• In addition to traditional offerings such as medical, dental, and vision care, we provide a comprehensive suite of benefits focusing on 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 promote your personal growth, we also offer various training programs, professional development resources, and opportunities to engage in mentorship programs, employee resource groups, volunteer activities, and more.