患者服务专员
Patient Services Specialist
我们的团队成员是所有工作的核心。在Cencora,我们共同肩负着创造更健康未来的责任,这里每个人都是实现这一目标的关键。如果你想在医疗健康的核心做出改变,加入我们创新的公司,帮助我们改善全球人们和动物的生活。立即申请!
职位详情
地点:远程办公
工作时间:与诊所营业时间一致(周一至周五上午8:30至下午5:00),适用于EST、CST或MT时区
要求:具备CPhT认证
职责:
- 根据患者和医生的需求,代表患者和医生执行患者入组、保险福利验证、事前授权、财务援助和申诉流程,以促进医生办公室和药房之间的流程,对处方进行分类和优化。
- 根据需求,为医疗系统的门诊药房、专科药房和/或门诊输液中心环境提供上述服务。
- 与患者和医生互动,获取保险福利和患者信息,以请求事前授权,确保药物和其他服务由保险公司报销。
- 确保获得与患者特定报销相关的信息,并可供审查和跟踪替换产品,包括维护PAP申请的文件和文档。
- 在向相应PAP提交申请之前,获取完成PAP申请所需的签名和文件。
- 完成患者依从性活动,可能包括通知即将到期的处方、协调、跟踪和确认处方配送。
- 在医疗系统的电子病历系统和其他适用系统(如IndiCare™)中工作,以支持流程管理和记录活动(如获取所需信息以提供服务、沟通状态和记录结果)。
- 为医疗系统及其组成部分提供集成服务,以提高处方捕获率,确保输液药物及时送达医院环境,改善患者预后并减少再入院。
- 主动解决可能影响指定设施报销的问题,并向患者准入管理团队提供详细更新。
- 与指定的诊所员工、药房和医院建立业务关系
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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!
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 arise.
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
Full timeEqual 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 . 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
Affiliated Companies: Value Apothecaries IncOriginally posted on Himalayas