Client Services Specialist II-Medbank (L1) Full-Time

Job Description

Job Description

Hourly Rate Range : $25.50 Per Hour (Full-Time 40 Hours per Week)

Employee Benefits: Medical, Dental, Vision all with Carefirst Blue Cross Blue Shield, Paid Time Off (Annual, Sick, Personal, Holidays), 403B Plan, Short-Term & Long Term Disability, Life Insurance.

Telework: This position is approved for hybrid in-person and telework. Job duties require at least two (2) days a week onsite at PCC. Note: PCC employees must reside in the following five states or District of Columbia: MD. VA, WVA, DE. PA, DC. Relocation expenses are not reimbursed

Primary Care Coalition (PCC) works to advance health equity by increasing healthcare access for vulnerable individuals without health insurance in Montgomery County. The Primary Care Coalition (PCC) envisions a strong, vibrant community that supports all people in achieving healthy lives. Our mission is to improve the health of vulnerable individuals and families by building public-private partnerships and strengthening systems. We help our community thrive by facilitating multi-partner programs that address health disparities and inequities across the healthcare continuum.

The Client Services Specialist, reporting to the Client Services Lead, is responsible for guiding clients through applying for assistance to obtain medications. This role involves reviewing applications to determine eligibility for Medbank, patient assistance programs from pharmaceutical companies, entitlement programs, and other medication resources. The Specialist also initiates referrals for clients to additional programs for which they may qualify or facilitates their enrollment as needed. Acting as a patient advocate, this position ensures that clients can access the medications they require.

Essential Duties

1. Offers guidance on pharmaceutical Patient Assistance Programs application and eligibility requirements: This role involves close collaboration with health centers, providers, patients, healthcare agencies to explain program application process and requirements.

• Provides guidance to providers, health center staff, and patients on the application process, eligibility criteria, and requirements of patient assistance programs

• Provides training to health center staff, providers, and program personnel on the eligibility and requirements of patient assistance programs.

• Responds to inquiries from health centers, providers, and clients regarding application processes, status updates, enrollment, medication refills, and delivery.

• Refers clients to other programs for which they may qualify, following program guidelines.

• Establishes and maintains relationships with service providers and community service professionals. Act as a liaison for questions or concerns regarding specific clients.

• Uphold the goodwill of clients during the program period and promote a positive image of PCC to both existing and potential clients.

2. Completes Patient Assistance Program applications, enrollment and refills: Processes patient assistance programs applications while collaborating closely with referring providers, patients, and patient assistance programs to ensure successful application outcomes and medication delivery.

• Facilitates the enrollment of eligible clients in appropriate programs. Complete and verify application forms and documentation.

• Submits complete application directly to relevant pharmaceutical companies’ patient assistance program.

• Reviews applications to ensure they are complete, including all required documents.

• Enter client information into a computer database and update it as needed.

• Monitors the status of applications after submission. Contact providers, clients, and patient assistance programs to verify patient approval and medication receipt.

• Completes clients’ enrollment recertification and process medications renewals as necessary.

• Maintain accurate documentation and records for programs and clients. Prepare client folders, file documents, send routine follow-up correspondence, and update client files as needed. Document daily activities.

• Provides ongoing administrative support to clients and providers by verifying eligibility status, mailing or faxing information, and following up on various inquiries.

• Performs other duties as assigned or as needed.

Skills and Abilities

• Demonstrated excellent oral and written communication skills and the ability to communicate effectively with a broad range of stakeholders including patients and families, clinicians, health centers staff, pharmaceutical companies’ patient assistance program representatives, PCC peers, and staff.

• Demonstrated competence and sound judgment in coordinating referrals to community resources and in enrolling clients in PCC medication programs.

• Ability to handle sensitive communications and interface with individuals in crisis.

• Demonstrated flexibility in dealing with organizational and regulatory changes and strong commitment to patient care.

• Excellent organizational and time management skills to manage caseloads with attention in detail.

• Ability to develop and maintain trusted relationships with pharmaceutical companies’ patient assistance program representative and coordinate services effectively on behalf of patients.

• Ability to work under pressure and handle multiple tasks simultaneously.

• Demonstrated understanding of medical terminology and reference resources regarding prescription medication (e.g., prescribing guide, Merck manual, Internet) and ability to communicate well with health care providers.

Education and Experience

• High school degree required. A bachelor’s degree or substantial work towards degree in psychology, social work, health care administration or related field is preferred.

• 3+ years’ experience in a medical office, health care, or social work environment.

• Demonstrate excellent customer service experience.

• Experience working with diverse, low-income families, whose primary language is something other than English.

• Proficiency in Microsoft Office (Excel, Word, Power Point), Microsoft Teams, Adobe Pro and SharePoint.

• Knowledge of health care systems including non-profit clinics, hospitals, and private sector as well as trends in public and private health insurance and managed care systems.

• Working knowledge of insurance eligibility and reimbursements.

• Bilingual (English/Spanish) with strong oral and written communication skills in both languages preferred.

ADA Requirements

This job operates in a professional office environment. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• This role routinely uses standard office equipment such as computers, telephones, photocopiers, filing cabinets and fax machines.

• This is largely a sedentary role; however, some filing may be required.

• This would require the ability to lift files, open filing cabinets and bend or stand as necessary.

• Requires ability to learn new software applications as necessary.

• Must be able to lift up to 20 pounds.

• Must be able to travel locally.

Disclaimer

This job description indicates in general the nature and levels of work, knowledge, skills, abilities and other essential functions as covered under the Americans with Disabilities Act expected of an incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of an incumbent. An incumbent may be asked to perform other duties as required. Primary Care Coalition is an Equal Opportunity Employer.

Primary Care Coalition is an Equal Opportunity Employer