Under close supervision of the Pharmacist or other supervisory/management-level position in the facility, obtains new prescription refill information from customers such as name, address and health coverage.
PRIMARY DUTIES AND RESPONSIBILITIES:
- Collaborates with internal team members to gather appropriate paperwork, prescription billing information, &/or prescriptions.
- Answers inbound telephone calls and triages calls to appropriate staff
- Responsible for creating a patient profile in the pharmacy information system.
- Enters all necessary prescription plan information in the patient profile for processing and adjudicating patient's prescriptions.
- Supports all Concierge Service related activities from prescription intake to bedside delivery at time of patient discharge.
- Complies with all established regulatory and organizational policies and procedures.
- Participates in program marketing and promotional campaigns.
- Assists in establishing policies and procedures specific to the Concierge Services Program including; indigent drug program, Patient Assistance Programs, and Pharmacy exception processes.
- Serves as primary Ambulatory Pharmacy resource to facilitate access and resolve all required discharge medication related issues. Including but not limited to; formulary/coverage issues, copay issues, patient assistance program eligibility, and other indigent programs.
- Prepares inventory reports for pharmacist review to purchase.
- Submits, receives, and places inventory in stock by utilizing knowledge of order placement, receiving, and merchandising.
- Provides follow-up to patients and family for pharmaceutical needs and/or additional eligibility information to ensure on-going medication access.
- Works with appropriate departments and internal patient care team members regarding patients who have limited financial resources for prescription medication and collaborates as required to create medication access to support discharge preparations.
- Collaborates with internal team members, insurance companies, drug manufacturers, and prescription benefit administrators to coordinate drug coverage or resolve denials.
- Provides education to pharmacy, and other patient discharge related departments regarding current policy and process as it pertains to the patient assistance program and pharmacy exception process.
- Participates in achieving clinical and business goals and metrics for the Ambulatory Pharmacy concierge Program.
- Assembles data and prepares concierge program reports.
- Performs other duties as assigned
EXPERIENCE AND EDUCATIONAL REQUIREMENTS:
Requires 3-5 years of experience in a community-based retail or hospital outpatient pharmacy or equivalent training and experience. Additional experience in any hospital setting or "lead" Technician experience is a plus. Associate's Degree program preferred. Pharmacy Technician certified with a state or national technical certification organization preferred (may be required in some states).
Demonstrated proficiency and process knowledge of outpatient prescription program payer/PBM billing, issue resolution, and payment processes-including Prior Authorization and Claim Exception Facilitation.
Understanding and process knowledge of medication billing systems in an ambulatory pharmacy setting
Demonstrated computer literacy-including Pharmacy Operating System experience and Word/Excel capabilities.
Prior POS and cash register experience required, Pharmacy POS/cash register experience desired
Direct experience and knowledge of Patient Assistance Programs and/or indigent drug programs is highly desired.
MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:
- Ability to communicate effectively both orally and in writing
- Ability to work quickly and accurately under time and volume constraints
- Strong interpersonal skills
- Ability to resolve customer issues quickly and creatively in order to improve customer satisfaction
- Ability to prioritize, facilitate, and problem-solve multiple time-sensitive tasks to completion.
- Strong organizational, record-keeping, and time management skills are essential
- Familiarity with pharmaceutical products, services and drug interactions
- Strong organizational skills; attention to detail
- Good analytical skills
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