Patient Support Pharmacy Solutions Coordinator

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

📋 Description

• Perform in-depth research on order and ticket history to suggest optimal resolutions in accordance with departmental guidelines.

• Ensure compliance with all Service Level Agreements (SLAs).

• Engage with relevant stakeholders to address issues necessitating cross-functional collaboration that could affect a positive patient experience.

• Cultivate strong relationships both internally and externally, maintaining positive interactions with customers and partners.

• Timely and accurately review and respond to internal escalation requests.

• Take the initiative to troubleshoot and resolve Prior Authorizations (PAs) and appeals through vendor portals; analyze determination trends to deliver valuable insights for patient education.

• Act as the expert intermediary between prescribers, insurance payers, and partner pharmacies, translating technical challenges into actionable solutions that guarantee patient access to therapy.

• Collaborate closely with Customer Support to provide clear, jargon-free updates and documentation in our operating systems, ensuring the team has the patient-ready insights essential to support the patient’s journey.

• Navigate multiple software systems and vendor portals efficiently with a self-starter approach, demonstrating flexibility in prioritizing tasks based on clinical urgency.

• Investigate complex claim rejections, collaborating with payers and pharmacies to identify root causes and establish a clear resolution pathway that adheres to regulatory requirements and manufacturer business rules.

• Serve as the primary technical problem-solver for orders that deviate from standard workflows, overcoming challenges such as insurance exceptions, pharmacy rejections, failed transfers, and state-specific shipping regulations.

⛳️ Requirements

• Must be a Licensed Pharmacy Technician in your state of residence.

• At least 3 years of experience as a professional pharmacy technician or in prior authorization roles.

• Proven skills in complex problem-solving and critical thinking.

• Highly resourceful, detail-oriented, and able to see complex issues through to resolution.

• Demonstrated ability to adapt to rapid changes in programs and processes.

• Familiarity with Zendesk, Phil Dashboard, and the organizational structure and processes of Phil.

• Good general understanding of computers, hardware, networks, and related technologies.

• Minimum of 3 months of tenure with Phil (for Internal Candidates).

• Consistent record of excellent attendance.

• Average performance scores of 95% in Quality Assurance (QA).

🏝️ Benefits

• Overtime (OT) and holiday work may be required.