Patient Care Coordinator in North Chicago, IL
- Title: Patient Care Coordinator
- Code: RCI-21503
- RequirementID: 106977
- Location: North Chicago, IL 60064
- Posted Date: 03/20/2023
- Duration: 12 Months
- Name:Siddhi Kadakia
- Email: email@example.com
- Phone: 908-704-8843 ✖ 277
What are the top 3-5 skills requirements should this person have?
- Customer Service
- Work ethic
- Listening skills
- Computer Proficient
What is a nice to have (but not required) regarding skills, requirements, experience, education, or certification?
- Call center background
- Pharmacy background
- Insurance background
What type of environment is this person working in?
- Group setting
- Individual Setting
- Combination of both
Work Schedule (Define days,# of hours)/ Is Overtime offered or required? If yes, how many hours, what impact to scheduled working hours?
- 5 days a week, 8.5 hours a day/ Overtime can range from offered to mandatory
- Hours open are 7am-7pm, new hires start with later shift but need to be open for flexability
- During the year, we may have mandatory overtime that could be up to 10 hours a week
6Does this position offer the ability to work remotely on a regular basis or is it an on-site role? If remote opportunity exists, what are the options (i.e. 1 day remote, 4 days on-site)?
- Agents will work onsite and have possibility to work remotely in the future based on preformance three months after training
- Training will be done 100% onsite
- Describe the primary goals, objectives or functions or outputs of this position.
- This position is responsible for providing inbound and outbound call support and best in class customer service to patients, physicians and physician's office staff, who utilize Pharmacy
- Solutions for benefit investigation and prescription procurement services. This role will also be responsible for securing patient's financial responsibility for their medications and
- assuring appropriate education materials are provided to the patient as requested. This
- position uses the core pharmacy system to manage their workload, perform their duties, and
- route work to other members of the Pharmacy Solutions operations in order to complete the
- benefit verification and prescription approval process.
List up to 10 main responsibilities for the job. Include information about the accountability and scope.
- Provide subject matter expertise of product coverage, insurance benefit coverage, Client sponsored co-pay cards and alternative forms of coverage for supported products.
- Assists patients with treatment compliance by scheduling and entering medication orders into the pharmacy information system.
- Enter patient demographic, health insurance, specific clinical/financial information, and prescription information into the pharmacy information system and notify the physician of any incomplete or incorrect prescription information; captures and updates patient Medical Profiles including medications, allergies, and medical conditions.
- Assist the pharmacist in the practice of pharmacy in accordance with federal, state, and local regulations, HIPAA guidelines, and corporate and departmental policies and procedures.
- Meet performance standards in alignment with predefined metrics.
- Contact patients to inform them of benefits and estimated out of pocket expense.
- Identifies potential Adverse Event situations for reporting to Pharmacovigilence ensuring Client meets FDA regulations.
- Completes all required training perform all functions in the position e.g., Soft Skills certification, product and disease overviews.
- Maintain current pharmacy technician licensure and CE requirements as necessary.
- List required and preferred qualifications (up to 10). Include education, skills and experience.
- High School Diploma or GED required. Associate or College Degree Preferred.
- Individuals must meet applicable Pharmacy Technician licensure and certification requirements at employment start date in accordance and compliance with the Illinois Pharmacy Practice Act.
- Previous experience in a call center environment, healthcare office, corporate setting, or healthcare insurance provider or pharmacy is highly desirable.
- Previous experience as a pharmacy technician, especially in a specialty pharmacy or mail-order pharmacy setting, is desirable.
- Understanding and knowledge of commercial and major medical insurance programs, billing requirements, healthcare benefit investigation processes, prior authorization and appeal filings.
- Must have accuracy, attention to detail, and fluency in the use of computers. Ability to type at least 30 words per minute.
- Must have organization and problem solving skills to handle patient conversations identify issues and address needs.
- Must be proficient with Microsoft Office Program Suite and Lotus Notes Suite including Excel, Word, Outlook and SharePoint.
- Must have knowledge of private payers, pharmacy benefits, medical benefits, Medicare Part D, Medicaid and alternate funding resources.
- Ability to maintain professional communication skills and an understanding of how to maintain a courteous attitude toward customers and fellow employees.
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