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 regulations.

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

• Confirm insurance coverage, review patient insurance cards, verify formulary information, and record coverage details.

• Assist with financial assistance enrollment by collecting eligibility data and completing manufacturer copay applications.

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

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

• Monitor pending prior authorizations, follow up with payers, and inform senior staff of any delays or denials.

⛳️ Requirements

• A High School Diploma/GED or equivalent experience is required.

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

• Completion of Health Insurance Portability and Accountability Act (HIPAA) or relevant compliance training is mandatory.

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