Specialty Pharmacy Patient Care Coordinator

Specialty Pharmacy Patient Care Coordinator

Specialty Pharmacy Patient Care Coordinators handle a broad variety of interactions with clients, providers, payers and manufacturers critical to the services provided by the Specialty Pharmacy. The core functions include handling incoming and outgoing client and patient interactions and follow thru and resolution of customer inquiries. Interactions include calls from patients, families, provider offices, payers, and manufacturers. Handles other miscellaneous tasks, including the reconciliation of delivery tickets, and investigating expired prescriptions and encounters. Handle every interaction with the utmost service and resolve; providing a patient/client experience that supports our commitment to efficient and effective connections to care. Interact with a diverse patient base to ascertain the reason for the interaction and assist the client with their inquiry, concerns or problems with a focus on first call resolution. Demonstrate commitment to service and follow-through. Follow departmental protocols to ensure patient safety and accurate data entry.

Essential Functions

• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
• Receive, handle, and triage calls/interactions accordingly based on client's needs including but not limited to: assessing refill needs, scheduling delivery of medications, copay collections, package & delivery tracking, obtaining payer/copay card information, status updates of orders, receiving/relaying information to the client.
• Practice First Call Resolution by identifying and assessing client needs to work towards a satisfactory solution.
• Assess for clinical escalation to pharmacist where appropriate.
• Accurately research and document all interactions within the Electronic Medical Record (EMR) per departmental policy and guidance.
• Access EMR and other software to answer, coordinate, track, and monitor interactions across multiple channels of communication. Maintain qualitative and quantitative individual and team performance targets.
• Identify issues and communicate solutions to customers, pharmacies, physicians, and payers regarding scheduling and delivery information, prescription order status, eligibility, and claims information.
• Effectively collaborate with internal departments and external entities to resolve customer issues, including billing, logistics, insurance coverage, and manufacturer copay card programs.
• Additional administrative and pharmacy tasks and duties may be assigned by management.

Competencies (Knowledge, Skills, and Abilities Required)

• Maintain knowledge of and comply with regulatory guidelines set forth by the State Board of Pharmacy, FDA, DEA, DHS, Medicare, TJC, and URAC as applicable to functional role.
• Demonstrated ability to listen skillfully, accurately collect & document relevant information, and build relationships and trust with clients.
• Knowledge of the major responsibilities, accountabilities, and overall organization of the client support function or department, ability to properly support client inquiries and bring problems to a timely resolution.
• Independently resolves complex client conflicts including but not limited to: damaged/lost products, order placement, and outstanding balances and invoices. Multi-task between several issues at one time.

Minimum Education and Experience Requirements

• Education: High School Diploma or GED equivalent preferred.
• Experience: 3+ years experience in customer service role 1+ years experience in a specialty pharmacy, hospital, health insurance company, benefits department or other related healthcare environment.

Minimum Certifications, Registration or License Requirements: None Required

Additional Information

• Proficient in the use of computers and Microsoft applications. Type 35 wpm.
• Experience with clinical software systems; Specialty Medications and Medicare billing is highly preferred.
• Ability to communicate professionally and efficiently in both written and verbal format with patients, physicians, payors and clinical staff in-person and on the phone.
• Flexibility to adapt to changes in the departmental needs including but not limited to: offering assistance to other team members, adjusting assignments, etc.
• Detailed orientated with excellent organization skills, ability to learn quickly, solve problems and make informed educated decisions.
• Ability to adapt in a dynamic work environment.
• Demonstrated ability to handle difficult conversations in a professional and caring manner.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Thomas Jefferson University Hospitals, Inc.

Primary Location Address

3500 Horizon Drive, King of Prussia, Pennsylvania, United States of America