Intake & Benefits Specialist (Infusion Pharmacy)

River’s Edge Pharmacy; Palm Desert (CA); Sur place; USD 28 000 - 34 000; Plein temps

Avantages offerts par ce poste

401(k) matching

Health insurance

Vision insurance

Flexible spending account

Life insurance

Employee assistance program

Referral program

Paid time off

Résumé du poste

River’s Edge Pharmacy in Palm Desert, CA is seeking a detail‑oriented coordinator to manage new referrals and refill specialty prescriptions within a patient‑care focused infusion therapy setting.

You will foster relationships with doctors, patients, and insurers, and navigate the specialty prescription lifecycle to ensure timely access and accurate billing.

This full‑time position requires strong communication, organization, and confidentiality to support therapy across multiple disease states.

Qualifications

• Thorough knowledge of Specialty Pharmacy laws and regulations.
• Proficient with Microsoft Office Suite or related software.
• Excellent verbal and written communication skills.
• Excellent interpersonal, negotiation, and conflict resolution skills.

Responsabilités

• Communicate with patients to obtain information required to process prescriptions, refills, access benefits and apply charges against co-pay cards, and build trusted and enduring customer relationships that yield loyalty.
• Investigate and verify benefits for pharmacy and medical third party claims for assigned cases. May communicate with financial assistance team of drug manufacturers to apply for and secure financial assistance for patient when assigned.
• Follow up with Pre-Authorization team to provide additionally required information, track progress, and maintain contact with customers to keep them continuously informed.
• Facilitate appeals process between the patient, physician, and insurance company by requesting denial information.
• Compose clinical appeal letters based on specific denial reason and patient’s clinical presentation. Ensure all clinical information and documentation are obtained prior to appeal submission. Coordinate appointment of representative document with patient and physician office.
• Complete status check with insurance company regarding appeal and approval or denial status. Obtain approval information and activate copay cards based on eligibility and specific drug prescribed.
• Track, report, and escape service issues arising from requests for authorizations, financial assistance or other issues that delay service, to ensure patient access and to avoid delays that may interrupt therapy.
• Build and maintain effective business relationships with prescriberstreating assigned set of disease states and provide ongoing communication of specific case-related information as appropriate.
• Complete a series of assessments mandated by either manufacturer contracts or operations. Facilitate patient enrollment with manufacturer hubs when required.
• Review notifications of patients in need of financial assistance to cover the cost of their prescriptions. Communicate with patients to provide information regarding assistance programs and community resources that provide the required assistance.
• Obtain required information and permission from patients and submit electronic applications for financial assistance on their behalf, or provide patients with forms required by assistance providers. Follow up with patients and assistance providers on status of claim to avoid interruption in therapy.
• Update all unfilled prescription activity status in the software every 48 hours.
• Ensure that work activities comply with the organization’s defined standards and procedures, and in a manner that provides the best available level of service and quality.

Connaissances

Pharmacy knowledge

Office software

Communication skills

Organization

Analytical thinking

Formation

High school diploma or equivalent

Associate or Bachelor’s degree in healthcare, life sciences, or business preferred

Outils

Microsoft Office

Description du poste

River’s Edge Pharmacy in Palm Desert, CA is seeking a detail‑oriented coordinator to manage new referrals and refill specialty prescriptions within a patient‑care focused infusion therapy setting.

You will foster relationships with doctors, patients, and insurers, and navigate the specialty prescription lifecycle to ensure timely access and accurate billing.

This full‑time position requires strong communication, organization, and confidentiality to support therapy across multiple disease states.