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

📋 Description

• Document patient interactions, update case notes in pharmacy systems, and ensure compliance with privacy standards.

• Handle prior authorization requests by gathering clinical documentation, filling out payer-specific forms, submitting requests, and monitoring their status.

• Confirm insurance coverage by examining patient insurance cards, reviewing formulary details, and recording coverage information.

• Assist with financial assistance enrollment by obtaining patient eligibility data, completing manufacturer copay applications, and submitting necessary paperwork to program administrators.

• Manage specialty pharmacy referrals by processing required forms, verifying insurance benefits, scheduling patient communications, and coordinating with specialty pharmacy teams.

• Address routine patient inquiries, provide status updates, respond to basic questions using provided scripts, and escalate more complex issues as needed.

• Monitor pending prior authorizations by keeping track of submission dates, following up with payers about their status, and informing senior staff of any delays or denials.

⛳️ Requirements

• High School Diploma/GED or equivalent experience is mandatory.

• A minimum of 3 years of experience in pharmacy support, prior authorization processing, insurance verification, or healthcare administrative roles is required.

• Training in Health Insurance Portability and Accountability Act (HIPAA) or relevant compliance is necessary.

• An Associate's degree in healthcare administration, life sciences, pharmacy technology, or a related field, or equivalent experience, is preferred.