Patient Support Pharmacy Solutions Coordinator

📋 Description

• Perform comprehensive research on order and ticket histories to suggest optimal resolutions that adhere to departmental guidelines.

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

• Communicate with relevant stakeholders to address issues requiring cross-functional collaboration that could affect a successful patient experience.

• Foster strong internal and external relationships, nurturing positive connections with customers and partners.

• Review and respond to internal escalation requests promptly and accurately.

• Proactively initiate, troubleshoot, and resolve prior authorizations (PAs) and appeals through vendor portals; analyze determination trends to provide insightful information for patient education.

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

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

• Efficiently navigate various software systems and vendor portals with a self-starter attitude, maintaining the ability to prioritize tasks based on clinical urgency.

• Investigate intricate claim rejections and work with payers and pharmacies to identify root causes and develop a clear resolution pathway that aligns with regulatory requirements and manufacturer business rules.

• Serve as the primary technical "fixer" 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.

• A minimum of 3 years of experience as a professional pharmacy technician or in prior authorization.

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

• Highly resourceful, detail-oriented, and capable of seeing complex issues through to resolution.

• Proven adaptability to rapid changes in programs and processes.

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

• General understanding of computers, hardware, networks, and associated technologies.

• At least 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.