Patient Care Coordinator

Johnson Service Group; Columbus (OH); Remote; USD 30,000 - 42,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k)

Job summary

Johnson Service Group is seeking a Patient Care Coordinator for the Pharmacy Insurance Team in Orange County. This is a remote opportunity with a Mon-Fri schedule and PST hours.

The role pays $26.00 per hour and involves supporting Microsoft Team chat and Outlook, handling 30–50 daily calls, and coordinating prior authorizations for members, pharmacies, and doctors. Ideal candidates have 1–3 years of PBM or retail pharmacy experience, a high school diploma, and strong communication skills.

Qualifications

• High school diploma required; 1–3 years PBM or retail pharmacy experience preferred.
• PTCB certification desirable.

Responsibilities

• Respond to member questions via phone, email and written correspondence about prescription drug benefits.
• Assist with coordinating Prior Authorization Requests between doctors, patients and pharmacies.
• Support Benefits Coordinators and CSRs with training and policy development.
• Resolve escalations to meet service level agreements.

Skills

PBM knowledge

Pharmacy claims

Prior authorizations

Customer service

Phone support

English fluency

Education

High school diploma

Tools

PTCB Certification

Job description

Johnson Service Group is seeking a Patient Care Coordinator for the Pharmacy Insurance Team in Orange County. This is a remote opportunity. Work Schedule: Mon-Friday; 7:30am- 4:30pm PST or 9:00am- 5:30pm PST Hourly Pay: $26.00 per hour. Job Summary: Support Microsoft Team chat messages, and Outlook emails throughout the day with a dependable availability to cover inbound calls from Monday- Friday. Approximately 30-50 calls handled per day. Familiarity with pharmacy insurance claim billing. Knowledgeable and comfortable with pharmacy operations such as communicating with members/ pharmacies/ doctors regarding Prior Authorizations questions.

QUALIFICATIONS

• High school diploma and one (1) to three (3) years of experience in Pharmacy Benefit Management or retail pharmacy practice, preferred.
• Valid Pharmacy Technician Certification Board Certification (PTCB), desirable.
• Intermediate knowledge of prescription benefits and products, and pharmacy claims.
• Patient Care oriented with ability to set priorities and meet required turn-a-round time frames.
• Excellent written and oral communication skills, as well as interpersonal skills.
• Good skills for project-based tasks.
• Ability to work effectively in a fast-paced environment
• Analytical thinking skills and problem-solving capabilities.
• Good communication and telephone skills
• Ability to adapt to a constantly changing environment.
• Proficient organizational and time management skills.
• Fluent in English (oral and written) required.

Bilingual in Spanish preferred.

DUTIES AND RESPONSIBILITIES

Customer Service

• Ability to respond to a wide-variety of member questions via telephone, e‑mail and written correspondence regarding prescription drug benefits in a confidential, professional and ethical manner such as confirming Prior authorization status, verifying patient eligibility & pharmacy benefits, and placing overrides for rejected pharmacy prescription claims.
• Assist Benefits Coordinator I & II with coordinating intake and processing Prior Authorization Requests between doctors, patients, and pharmacy.
• Provide support to Benefits Coordinator II with training CSRs to handle customer service inquiries.
• Assist the Benefits Coordinator II in developing policies and procedures for our customer service agents.
• Provide assistance to Benefits Coordinator I & II and Supervisor in resolving all escalations in a timely manner to meet our Service Level Agreements.
• Responsible for the PBM customer service Help Desk for day-to-day tasks. Prior Authorization tickets, after hours voicemails/ emails, customer service e‑mails, and direct member reimbursements.
• Provide the Benefit I coordinator support to develop client‑facing reporting and communications.
• Responsible for implementing “white glove” customer service expectations for the PBM.

Operations

• Achieve service level targets with our e‑mail box, Prior Authorization tickets, organizing documents in the H drive, and other areas of pharmacy operations.
• Utilize creative methods to understand how our customers perceive their interactions with Pinnacle Rx Solutions and the process for getting their medications.
• Provide suggestions and contribute to workflow improvements.
• Contribute to team of highly skilled and talented experts who maintain the current reporting environment and work to continually improve it by delivering operational reporting products, including critical metric reporting, performance dashboards, work‑in‑progress trackers and forecasting.
• Back‑up and assist the Benefits Coordinator I & II in performing process Improvements, reporting and analytics, project management, and quality assurance activities.

Other

• Utilize all capabilities to satisfy one mission —to enhance the competitiveness and profitability of our members. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning, and executing work helpfully and collaboratively. Be willing to adjust efforts to ensure that work and attitude are helpful to others, being self‑accountable, creating a positive impact, and being diligent in delivering results.
• Focus efforts on quality and quantity of product deliverables as well as resourcing and project management in a fast paced and challenging environment.
• Ensure application compliance while creating an environment for innovation and growth.
• Maintain internet speed of 40 MB download and 20 MB upload and router with wired Ethernet.
• Home router with wired Ethernet (wireless connections and hotspots are not permitted).

Other duties as assigned

JSG offers medical, dental, vision, life insurance options, short‑term disability, 401(k), weekly pay, and more.

Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.

#D800, #LI-EP1