Patient Care Coordinator in North Chicago, IL

What are the top 3-5 skills requirements should this person have?

• Customer Service
• Work ethic
• Empathetic
• Agile
• 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

Purpose:

• 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.

Responsibilities:

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.

Qualifications:

• 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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