New

Patient Care Coordinator III

TEKsystems
$20.00 - $23.00 / hr
medical insurance
United States, Florida, Orlando
Jan 09, 2025
Description 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. Provide subject matter expertise of product coverage, insurance benefit coverage, Company 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 Company meets FDA regulations. Completes all required training perform all functions in the position e.g., Soft Skills certification, product and disease overviews. Skills call center, customer service, insurance verification, healthcare customer service, health insurance, pharmacy, bilingual Top Skills Details call center,customer service,insurance verification Additional Skills & 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. Previous experience in a call center environment, healthcare office, corporate setting, or healthcare insurance provider or pharmacy is highly 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. Experience Level Entry LevelDescription 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. * Provide subject matter expertise of product coverage, insurance benefit coverage, Company 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 Company meets FDA regulations. * Completes all required training perform all functions in the position e.g., Soft Skills certification, product and disease overviews. Hours * Will be assigned a shift between 7am-7pm Mon-Fri Qualifications * 2+ years of healthcare call center experience (75+ calls daily; inbound and outbound) * 2+ years with medical insurance experience including Medicare and Medicaid (insurance verification, financial counseling, etc.) * Valid Pharmacy Technician License * High School Diploma Pay and Benefits The pay range for this position is $20.00 - $23.00 About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.