The Pharmacy Patient Advocate supports the enrollment process and patients in accessing coverage for their prescribed medications through inbound and outbound telephone support, as well as administrative functions.
Responsibilities
Review and process patients’ enrollment forms to the Patient Assistance Program (PAP)
Assist patients on the phone with PAP program enrollment by verifying the pre-screening and qualifying tasks.
Notify patients and health-care providers of approvals, denials, and any next steps needed to continue the enrollment process
Schedule treatments to be sent to the patient or patient’s health-care provider
Support inbound and outbound phone lines for the PAP program
Communicate daily with patient/authorized representative on eligibility based on PAP criteria and health-care providers to manage expectations.
Contact patient/authorized representative to determine supplementary information needed to enroll into the manufacturer’s PAP program.
Prioritize workload to ensure patients’ enrollments are processed within specified time-frame
Explain the PAP program and services to patients, authorized representatives, healthcare providers and physician’s office staff.
Respond to program inquiries from patients, authorized representatives, health-care providers, patient advocates and caregivers.
Report adverse events/product complaint inquires received in accordance with standard operating procedures and current good manufacturer practices.
Execute day-to-day operations specific to the assigned program(s).
Maintain patient confidentiality at all times.
The above duties are meant to be representative of the position and not all-inclusive.
REQUIRED EDUCATION AND EXPERIENCE:
High school diploma or equivalent
Two (2) years of work experience in a customer service or customer focused role
One (1) year of work experience in a call center environment.
Experience with insurance and benefit investigations; knowledge of U.S. Private and Government payers
Must have proven ability to provide consistently high-quality of service
PREFERRED EDUCATION AND EXPERIENCE:
Associate Degree or technical school training in a related field
Two (2) years of work experience in pharmacy, managed care, Medicaid and/or Medicare organizations, pharmaceutical and/or biotech manufacturer, insurance, medical office, or related field
Experience with HIPAA and patient services
Bi-lingual, English and Spanish
KNOWLEDGE, SKILLS & ABILITIES:
Demonstrated empathy and compassion
Excellent verbal and written communication skills
Excellent organization skills and detail oriented
Balance multiple priorities to meet expected response deadlines
Adaptable, flexible and readily adjust to changing situations
Ability to work independently and as a member of a team
Ability to comprehend and apply basic math principles
Ability to apply logical thinking when evaluating practical problems
Ability to present information and respond to questions from stakeholders
Ability to interact with a diverse group
Ability to listen and demonstrate a high degree of empathy
Demonstrated computer skills includes Microsoft Word, Excel, and Outlook
Display tact and diplomacy in response to unfavorable or negative situations
Demonstrated sensitivity and understanding when speaking with patients
Demonstrated passion for speaking with people in an outgoing way
PHYSICAL REQUIREMENTS:
Location of job activities 100% inside
Extensive manual dexterity (keyboarding, mouse, phone)
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential
The expected base pay range for this position is $19–$24 per hour. The actual compensation for the position may vary based on market differences and on factors such as skills, experience, qualifications and can vary based on location and/or work schedule. In addition to base pay, CareTria offers a comprehensive benefits package. Full-Time benefits include access to health, dental, and vision insurance; retirement plan options; paid time off; paid parental leave; employee assistance programs; and other perks. Eligible employees may also have access to performance bonuses.
CareTria is an Equal Opportunity Employer.