Patient Care Coordinator- Specialty Pharmacy, KOP

Job Details

Job Description

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):
Competency
Description
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
Knowledge of and ability to utilize practices, tools, and techniques for communicating with a client
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
AND

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.

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

Worker Sub Type

Primary Location Address

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.