Patient Services Specialist (Remote)
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. Apply today!
What you will be doing
**Hours: Monday through Friday 8AM-5PM EST**
**A current Florida Pharmacy Technician License is preferred**
The incumbent is responsible for conducting benefit verification and completing necessary third party prior authorizations, reimbursement activities, patient assistance and copay program enrollments. The Patient Services Specialist also coordinates refill calls, performs documented adherence activities, and coordinates dispensing for specialty medications, high cost prescriptions, and/or infusion medications. This role requires proactive interaction with physicians, office staff, patients, payers, and patient assistance programs. Occasional travel may be required.
- Perform patient onboarding, benefit verification, prior authorization, and appeals, 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.
- Provide above services for a health system’s ambulatory pharmacy, specialty pharmacy and/or outpatient infusion center environment, as requested.
- Verify benefits on both pharmacy and medical coverage, as appropriate.
- Interact with patients and providers to obtain insurance and patient information needed to request prior authorizations so that medications and other services rendered are reimbursed by payer.
- Communicate with clinic staff, pharmacy/infusion center and patient on the status of the request.
- Complete patient adherence activities that may include notification of upcoming refills, coordination, tracking, and confirmation of prescription delivery.
- Work within health system’s electronic medical record system and other applicable systems to retrieve information needed to deliver services, communicate status and document outcome.
- Research various payers to understand their prior authorization and appeals processes.
- Utilize software to support workflow management and to document activities. Follow defined policies and procedures, meet productivity and quality expectations.
- Responsible for facilitating patient enrollment into manufacturer and/or foundation sponsored patient assistance programs.
- Demonstrate flexibility and adapt to changes in payer, pharmacy and patient assistance program processes and requirements.
- Establish relationships with assigned clinic staff, pharmacy and hospital contacts, and keep them informed of patients’ status and payer challenges.
- Provide integrated services to health system and its component parts to increase prescription capture rate, improve patient outcomes and reduce readmissions.
- Communicate patient and provider feedback to PHS management to enhance process improvement and continuity of care.
- Provides temporary coverage to support clients and patients in the event of onsite resource absences.
- Performs additional related duties as assigned.
What your background should look like
Normally requires a minimum of two (2) years in fields such as Benefit Verification, Prior Authorization, Medical Billing, Medical Office Administration, Social Work, Medical Records, Patient Financial Services, Pharmacy, Nursing or similar vocations. Bachelor's degree program preferred. Previous prior authorization experience preferred. Pharmacy Technician Certification Board (PTCB) or Certified Medical Assistant (CMA) or state certification as required by Board of Pharmacy or obtained within six months.
- A Florida Pharmacy Technician License is preferred but not required
- 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
- Demonstrated competence in Microsoft Excel and Word
- Strong interpersonal skills
- Ability to resolve issues quickly and creatively in order to improve customer satisfaction
- Familiarity with insurance/claims processing, pharmaceutical products, services, software, and drug interactions
- Good analytical skills
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/amerisourcebergen
Affiliated CompaniesAffiliated Companies: Value Apothecaries Inc
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.