• Acts as a liaison between specialty pharmacy, patients, insurance companies, Pharma manufacturer and providers offices via phone, fax, online and e-mail communications

• Will be primary point of contact for client inquiries and escalations

• Resolves customer issues, ensuring timely and accurate information is provided. Determines cases that are falling outside timing parameters and provides resolutions

• Collaborates with Patient Care department, Pharmacy Operations and Trade Relations to ensure customer requests are handled in a timely and accurate manner. Works with other departments throughout prescription fulfillment

• Collaborates with Patient Care/COE teams, Clinical staff, Fulfillment Pharmacy, Trade Relations, Billing/Adjudication, Contracting, and Sales to provide a team approach to onboarding new patients

• Contacts provider or patient to obtain accurate information to continue processing the prescription

• Triages and resolves issues or concerns relating to product prescription coverage to the appropriate team (i.e. prior authorizations, appeals, grant funding, clinical)

• Works with the pharmacist and/or nurse to contact providers and insurance companies to verify prescriptions, overrides and other approvals

• Participates with Trade Relations in relevant Quarterly Business Reviews (QBRs) as needed

• Builds rapport with internal and external customers to promote the highest customer service and positive image of the company

• Provides data updates and ad hoc reports to manufacturers and HUBs as requested

• Interprets and disseminates information, including key information about updates or changes in the assigned product and/or program details

• Assists in the development of programs for data collection, adverse event reporting, and adherence as related to contractual agreements

• Adheres to all company policies as indicated in the handbook and directives issued by management. Has reviewed Policy and Procedure manual

• This is an office based position

Professional Competencies:

• A passion for helping patients. Organized, high-integrity, attention to detail, ability to multi-task and work independently, dependable, quality focused, empathetic, good listener/communicator, able to effectively transfer knowledge to others. Energetic, outgoing, highly motivated team player.

• Proficient with MS Excel, Word, and Outlook. Ability to comprehend and apply principles of basic math while analyzing data and generating reports.

• Ability to apply principles of logical thinking to a wide range of intellectual and practical problems.

• Strong oral, written and interpersonal skills. Ability to effectively educate, train and present information and respond to questions from groups of coworkers, managers, clients and customers.

• Excellent customer service with the ability to work with all levels of internal management and staff, as well as outside clients and vendors.

Required Qualifications:

• Experienced pharmacy technician with national CPhT certification. At least 3 years of prior pharmacy technician experience is preferred

• Working knowledge of specialty pharmacy; demonstrated understanding of specified disease state(s), competitors, healthcare industry trends, etc.

• Experience with insurance verification, healthcare benefit assessment, paperwork and documentation for billing Medicare/Medicaid and commercial insurances preferred

• HIPAA trained and /or the ability to work with and protect extremely confidential patient and employee information

• Two years of experience in a physician’s office, healthcare setting and/or insurance background preferred

• Ability to travel as needed

Educational Requirements: 

Bachelor’s degree in a related field preferred

Licensure and Certification Requirements:

Current unrestricted state pharmacy technician registration/licensure.

National or state pharmacy technician certification per applicable State Board of Pharmacy requirements.

Physical Requirements:

• Must be able to remain in a stationary position up to 90% of the time

• The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc., and traverse conferences, meetings, and remote events.

• Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer.

• The ability to communicate information and ideas so others will understand. Must be able to exchange accurate information in these situations.

• The ability to observe details at close range (within a few feet of the observer).

Working Conditions:

Normal office environment.

Equipment Used to Perform the Job: