Patient Services Specialist

Cencora, Inc.; Florida; Híbrido; USD 43 000 - 52 000; Tempo integral

Resumo da oferta

Cencora, Inc. is seeking a Pharmacy Support Specialist for a remote role focused on patient onboarding, benefit verification, and prior authorizations.

You will work with ambulatory and specialty settings to facilitate reimbursement and ensure timely prescription fulfillment. The role requires CPhT certification and 2+ years in medical office administration or patient financial services, with strong Excel/Word skills and excellent communication.

Qualificações

• 2+ years of related experience in medical office administration or patient financial services.
• Bachelor's degree preferred.
• PTCB certification required.

Responsabilidades

• Performs patient onboarding, benefit verification, prior authorization, financial assistance and appeals processes, as needed, on behalf of patients and their physician to facilitate the process between the doctors’ office and pharmacy to triage and streamline prescription fulfillment.
• Provides services for a health system’s ambulatory pharmacy, specialty pharmacy and/or outpatient infusion center environment.
• Interacts with patients and providers to obtain insurance benefits and patient information needed to request prior authorizations so that medications and other services rendered are reimbursed by payer.
• Ensures patient-specific reimbursement information is obtained and available for review and for tracking of replacement product, including PAP submissions.
• Obtains signatures and documentation for completed PAP applications prior to submission to PAP.
• Completes patient adherence activities including refills notifications and delivery coordination.
• Works with the health system’s EMR and IndiCare™ to support workflow and document outcomes.
• Provides integrated services to increase prescription capture rate and improve patient outcomes.
• Resolves barriers that affect reimbursement and updates the Patient Access Management team.
• Establishes business relationships with clinic staff, pharmacy, and hospital contacts regarding recovery potential changes.
• Assists on special projects to improve reimbursement optimization.
• Communicates patient/provider feedback to PHS management to enhance process improvements.
• Interfaces with key account associates regarding additional products and services.
• Demonstrates flexibility to changes in payer and PAP processes.
• Provides temporary coverage to support clients/patients during resource absences.

Conhecimentos

Effective communication

Organizational skills

Attention to detail

Time management

Microsoft Excel & Word

Analytical skills

Interpersonal skills

Insurance/claims familiarity

Formação académica

2+ years related experience in medical office administration or patient financial services

Bachelor's degree preferred

PTCB certification required

Ferramentas

IndiCare™

EMR systems

Descrição da oferta de emprego

Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and animals everywhere.

Job Details

Location: Remote

Office Hours: Mirror clinic hours (Monday through Friday 8:30 am to 5 pm) in either EST, CST, or MT time zones

Required: CPhT certification

Responsibilities

• Performs patient onboarding, benefit verification, prior authorization, financial assistance and appeals processes, as needed, on behalf of patients and their physician to facilitate the process between the doctors’ office and pharmacy to triage and streamline prescription fulfillment.
• Provides above services for a health system’s ambulatory pharmacy, specialty pharmacy and/or outpatient infusion center environment, as requested.
• Interacts with patients and providers to obtain insurance benefits and patient information needed to request prior authorizations so that medications and other services rendered are reimbursed by payer.
• Ensure patient-specific reimbursement related information is obtained and available for review and for tracking of replacement product, including maintenance of files and documentation for PAP application submissions.
• Obtains appropriate signatures and documentation for completed PAP applications prior to submission of the application to the respective PAP.
• Completes patient adherence activities that may include notification of upcoming refills, coordination, tracking, and confirmation of prescription delivery.
• Works within health system’s electronic medical record system and other applicable systems (i.e., IndiCare™) to support workflow management and to document activities (i.e., retrieve information needed to deliver services, communicate status, and document outcome).
• Provides integrated services to the health system and its component parts to increase prescription capture rate, ensure timely delivery of infusion medications to be infused in the hospital setting, improve patient outcomes and reduce readmissions.
• Resolves barriers proactively that may affect reimbursement at assigned facilities and provides detailed updates to the Patient Access Management team.
• Establish business relationships with assigned clinic staff, pharmacy, and hospital contacts, keeping them informed of significant changes in site‑specific recovery potential based on changes to PAPs.
• Readily assists on special projects within job scope to improve reimbursement optimization when requested by management.
• Communicates patient and provider feedback to PHS management to enhance process improvement to enhance continuity of care.
• Interfaces appropriately with assigned key account associates with information relevant to additional products and services provided by Cencora and its subsidiaries.
• Demonstrates flexibility and adapts to changes in payer, pharmacy and patient assistance program processes and requirements.
• Provides temporary coverage to support clients and patients in the event of onsite resource absences.
• Performs related duties as assigned.

Education

• Degree, technical vocational training, or equivalent combination of experience and education.
• Bachelor's degree program preferred.
• Pharmacy Technician Certification Board (PTCB) certification is required.

Work experience

• This position requires broad training in fields such as Medical Office Administration, Social Work, Medical Records/Billing, Benefit Verification, Patient Financial Services, Pharmacy, Nursing, or similar vocations generally obtained through completion of a 2‑year Associate 2+ years of directly related or relevant experience.

Skills and knowledge

• Ability to communicate effectively both orally and in writing.
• Strong organizational skills; attention to detail.
• Ability to work quickly and accurately under time and volume constraints.
• Ability to be proactive and tenaciously seek solutions under minimum supervision to improve customer satisfaction.
• Demonstrated competence in Microsoft Excel and Word.
• Strong analytical skills.
• Strong interpersonal skills.
• Familiarity with insurance/claims processing, pharmaceutical products, services, software, and drug interactions.

Physical requirements

The physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Sedentary physical activity requiring reaching, sifting, lifting, finger dexterity, grasping, feeling, repetitive motions, talking and hearing. Visual requirement is for close vision, distance vision, peripheral vision, and ability to adjust focus. 75% or more time is spent looking directly at a computer. Associate is frequently required to stand, walk (or otherwise be mobile). Ability to deal with stressful situations as they

What Cencora offers

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more.

For details, visit https://www.virtualfairhub.com/cencora

Full time

Equal Employment Opportunity

Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law. The company’s continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory. Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email [e-mail]. We will make accommodation determinations on a request‑by‑request basis. Messages and emails regarding anything other than accommodations requests will not be returned.

Affiliated Companies

AmerisourceBergen Drug Corporation

Cencora is a leading global pharmaceutical solutions company that is committed to improving the lives of people and animals everywhere. We connect manufacturers, providers, and patients to ensure that anyone can get the therapies they need, where and when they need them. We're a purpose‑driven organization, where all of our team members around the world are united in our responsibility to create healthier futures. We work together every day to help our partners bring their innovations to patients worldwide, creating unparalleled access and impact at the center of health.