Patient Access Coordinator – Remote After Training – Health Insurance Exp Preferred

Company: Kroger

Industry: Private

Employment Type:- Full Time

Work Hours:-  8 Hours

Locations:- USA

Full Job Description:-

Perform duties to assist patients with access to benefits and co-pay cards, and schedule delivery of prescriptions provided through the specialty pharmacy, working within the limits of standard or accepted practice. Demonstrate the company s core values of respect, honesty, integrity, diversity, inclusion, and safety. – Communicate with patients to obtain information required to process prescriptions, refills, access benefits and apply charges against co-pay cards

  • Investigate and verify benefits for pharmacy and medical third-party claims for assigned cases
  • Complete status check with insurance company regarding receipt/outcome of prior authorization and appeal; obtain approval information and activates copay cards based off of eligibility and specific drug prescribed
  • Track, report and escalate service issues arising from requests for authorizations, financial assistance or other issues that delay service
  • Notify patients when their prescription has been transferred and follow up with specialty pharmacy to confirm the prescription was received (in some jurisdictions)
  • Coordinate verbal transfer by a pharmacist if specialty pharmacy has no record of prescription (in some jurisdictions); confirm with patient that prescription was received from alternate specialty pharmacy
  • Complete a series of assessments mandated by either manufacturer contracts or operations and facilitates patient enrollment with manufacturer Hubs when required
  • 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
  • Perform or assist with any operations, as required to maintain workflow and to meet business needs
  • Perform other related duties as assigned
  • Must be able to perform the essential job functions of this position with or without reasonable accommodation

Minimum

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  • High School Diploma or GED
  • 1 year of proven work experience in a healthcare or customer service industry
  • Superior telephone customer service skills
  • Demonstrated strength in listening, oral and written communications in English
  • Excellent data management software skills with demonstrated adaptability to internal systems
  • Demonstrated ability to manage a range of priorities and meet time commitments
  • Excellent knowledge of insurance benefit investigation process and techniques
  • Strong organization skills as well as attention to detail

Desired

  • Any additional training in pharmacy/medical benefit access and requirements
  • Any previous experience in a call center preferred where performance was measured
  • Any healthcare experience with a basic understanding of clinical terms and benefits investigation

Patient Access Coordinator – Remote After Training – Health Insurance Exp Preferred

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