Patient Care Coordinator

RXinsider LTD.; Northern (KY); On-site; USD 36,000 - 52,000; Full time

Job summary

RXinsider LTD. is seeking a Patient Care Coordinator in the Patient Support Center/Call Center. The role reports to the Sr. Director Operations and is non-exempt under FLSA.

The incumbent will manage prescription intake, prior authorizations, and appeals, while ensuring data accuracy and outstanding customer service. Hours align with core Patient Support Center times, including evenings and weekends as needed.

Qualifications

• Minimum of 2 years pharmacy experience preferred.
• Must have pharmacy technician licensure or registration.
• Previous work experience in a call center environment or customer service role preferred.
• General knowledge of pharmacy laws, practices and procedures.
• Knowledge of common medical terms/abbreviations and pharmacy calculations.
• Understanding of insurance and third-party billing systems.
• Capability of working independently and as a team member.
• Ability to preserve confidentiality of PHI.

Responsibilities

• Complete prescription intake process including verification of insurance coverage.
• Assist physician’s offices through the prior authorization and appeals process.
• Research financial assistance options for patients through copay cards, foundations, and assistance programs.
• Coordinate prescription processing and delivery with dispensing pharmacies.
• Manage high volume of customer service calls while handling day-to-day operations.
• Build relationships with physicians, manufacturers, pharmacies, patients, and team members to optimize workflow.
• Ensure proper documentation of process flow from initiation to completion.
• Provide timely updates to physicians, pharmacies, and manufacturers regarding status.
• Interface with IT to improve system functionality and workflow.
• Attend team meetings to support program development.
• Other responsibilities as assigned.

Skills

Communication

Organization

Time management

Tools

MS Word

Excel

Outlook

Job description

Position: Patient Care Coordinator

Department: Patient Support Center/Call Center

Reports To: Sr. Director Operations

FLSA Non-Exempt

Primary Function

The incumbent is responsible for executing program requirements, managing daily workflow, providing accurate and complete data input, managing pre-certifications, and providing high levels of customer service.

Our core Patient Support Center hours are 8:00am to 11:00pm EST, Monday through Friday, and 8:00am to 8:00pm EST, Saturday and Sunday.

Job Scope And Major Responsibilities

• Complete prescription intake process including verification of insurance coverage
• Assist physician’s offices through the prior authorization and appeals process
• Research financial assistance options for patients through copay cards, foundations, and assistance programs
• Coordinate prescription processing and delivery with dispensing pharmacies
• Manage and triage high volume of customer service phone calls while managing day to day operations
• Build relationships with physicians, manufacturer sales representatives, pharmacies, patients, and other team members to optimize workflow and achieve program goals
• Ensure proper documentation of process flow from prescription initiation through completion
• Provide timely updates to physicians, pharmacies, and manufacturers regarding prescription status
• Interface with IT department to improve system functionality and workflow
• Attend team meetings to support ongoing program development
• Other responsibilities as assigned
• Success in this position is defined by high levels of customer service and timely processing of prescriptions through all phases
• Compliance with the provisions of the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations, as amended ("HIPAA")

Performance Criteria

Performance in this role is measured by accurate and timely routing of referrals and reporting as well as high levels of customer service.

Required Qualifications

• Minimum of 2 years pharmacy experience preferred
• Must have pharmacy technician licensure or registration
• Previous work experience in a call center environment or customer service role preferred
• General knowledge of pharmacy laws, practices and procedures
• Knowledge of common medical terms/abbreviations and pharmacy calculations
• Understanding of insurance and third-party billing systems
• Skill to prioritize and work in a fast-paced environment
• Exemplary communication, organization, and time management skills
• Capability of working independently and as a member of a team
• Ability to preserve confidentiality of protected health information (PHI)
• Proficient in MS Word, Excel and Outlook
• Possess and maintain professional demeanor and courteous attitude

Asembia is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, gender identity and expression, citizenship, genetic disposition, disability or veteran's status or any other classification protected by State/Federal laws .