Personal Care Specialist

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

📋 Description

• Assists in ensuring documentation compliance by logging patient interactions, updating case notes within pharmacy systems, and upholding privacy regulations.

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

• Confirms insurance coverage by examining patient insurance cards, reviewing formulary information, and recording coverage specifics.

• Aids in financial assistance enrollment by collecting patient eligibility information, completing manufacturer copay applications, and submitting necessary documents to program administrators.

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

• Addresses routine patient inquiries by providing status updates, responding to basic questions with supplied scripts, and escalating more complex issues.

• Monitors pending prior authorizations by tracking submission dates, following up with payers regarding status, and informing senior staff of any delays or denials.

⛳️ Requirements

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

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

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

• Health Insurance Portability and Accountability Act (HIPAA) or applicable compliance training is essential.

🏝️ Benefits

• Health insurance.

• A comprehensive suite of benefits focusing on wellness.

• Support for working families, including backup dependent care, adoption assistance, infertility coverage, paid parental leave, and paid caregiver leave.

• Professional development resources.

• Opportunities to engage in mentorship programs and volunteer activities.