Pharmacy Intake Representative

This Jobot Job is hosted by: Cody Timm

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Salary: $22 - $28 per hour

Our client has become a leader in infusion therapy services. Administered by specially trained infusion nurses, these services are provided at standalone locations, physicians’ offices, or in the home of the patient. Each location provides individualized care in a private setting for procedures including IVIG, Hemophilia, Chemotherapy, TPN, and Pain Management.

• Competitive pay
• Bonus pay opportunities
• 401k matching
• 100% employer-paid medical insurance
• Life and Disability insurance
• PTO and Holiday Schedule

• 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.
• Obtain prior authorizations; initiate requests, follow up to provide additionally required information, track progress, and expedite responses from insurance carriers and other payers, and maintain contact with customers to keep them continuously informed. Review for accuracy of prescribed treatment regimen prior to submission of authorization.
• Facilitate appeals process between the patient, physician, and insurance company by requesting denial information and facilitates obtaining the denial letter from the insurance, patient, or physician. Composes clinical appeals letters based off of specific denial reason and patients’ clinical presentation.
• Ensures all clinical information and documentation are obtained prior to appeal submission. Coordinates appointment of representative document with patient and physician office.
• Completes status check with insurance company regarding receipt of prior authorization and appeal and approval or denial status. Obtains approval information and activates copay cards based off eligibility and specific drug prescribed.
• Track, report and escalate 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.
• Completes a series of assessments mandated by either manufacturer contracts or operations and facilitates patient enrollment with manufacturer Hubs when required.
• Receive notification 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 of their behalf, or provide patients with forms required by assistance providers, follow up to offer assistance to complete documents properly, and ensure that applications are filed in keeping with defined time limits to avoid interruption in therapy.
• Follow up with assistance providers to determine the status of applications, expedite consideration of requests, advocate on behalf of patients, and track the status of applications and related activity.
• Document case activity, communications, and correspondence in computer system to ensure completeness and accuracy of patient contact records.
• Ensure that work activities are conducted in compliance with regulatory requirements and the organization’s defined standards and procedures, and in a manner that provides the best available level of service and quality.

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