EVERSANA

  • Patient Service Coordinator

    Job Locations US-AZ-Scottsdale
    Job ID
    2019-4524
    # of Openings
    4
    Category
    Patient Support Services
  • Overview

    OUR CULTURAL BELIEFS

    Patient Minded I act with the patient’s best interest in mind.

    Client Delight I own every client experience and its impact on results.

    Take Action I am empowered and empower others to act now.

    Grow Talent I own my development and invest in the development of others.

    Win Together I passionately connect with anyone, anywhere, anytime to achieve results.

    Communication Matters I speak up to create transparent, thoughtful and timely dialogue.

    Own It I hold myself and others accountable for results.

    THE POSITION:

    The Patient Service Coordinator (PSC) is responsible for coordinating the Lifetime Care of the patient as well as being a resource for the physician and their staff. The PSC assists patients with navigating their healthcare benefit in an effort to minimize the financial burden of the lifetime therapy they require. From the submission of a prescription; to ongoing patient contact; with consistent follow –ups required to ensure compliance with therapy the PSC guides those involved with the patient through the entire evolution of care for the Life Time Therapy they require. This includes verifying benefits, obtaining prior authorizations, assisting with medical appeals and coordinating other financial assistance as needed. They will partner with internal departments to resolve customer issues as necessary.

    Responsibilities

    ESSENTIAL DUTIES AND RESPONSIBILITIES:
    Our people leaders are tasked with delivering excellent business results through the efforts of their teams. These results are achieved by:

    • Setting clear direction, effective plans and measurable outcomes
    • Acts as the primary point of contact for patients established on therapy; acts as a patient advocate and resource throughout the lifetime of care
    • Contacts patients monthly to coordinate care needed, including medication refills, creating patient orders and associated prescription entry for refills; Assists with any obstacles, concerns patient may have in order to ensure ongoing compliance with medication regimen
    • Completes supply orders and process patient returns as needed
    • Communicate with prescribers as needed, including requesting new prescriptions
    • Coordinate with nursing as needed for in home care
    • Manage Fedex exceptions and notify patients as appropriate
    • Triage adverse events to appropriate clinical resource
    • Adjudicate PBM Claims; verify payment amount and resolve any nonpayment issues
    • Verify benefits monthly, prior to shipment
    • Obtain and maintain prior authorizations, including obtaining needed clinical information necessary to submit authorization. Assist with appeals as needed.
    • Identify, educate and assist patients to secure appropriate financial assistance when requested
    • Review and send monthly patient statements for medical and PBM claims < 90 days and answer patient inquiries as needed
    • Handle inbound and outbound calls Bill secondary, patient balance, PBM Plus or other PBM insurance as needed
    • Coordinate wholesale distribution to an authorized facility as needed. Review wholesale facilities to ensure licensure is correct and up to date; update and maintain facility application
    • All other duties as assigned

    Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.

     

    MINIMUM KNOWLEDGE, SKILLS AND ABILITIES:

    The requirements listed below are representative of the experience, education, knowledge, skill and/or abilities required.

    • High School Diploma or GED
    • 1 years reimbursement experience required; including knowledge of pharmacy benefit and medical benefit insurance coverage
    • Strong communication, problem solving, and customer service skills
    • Ability to adapt and successfully handle unexpected situations
    • Current Missouri Pharmacy Technician registration or the ability to obtain
    • Computer proficiencies, including Microsoft office

    Qualifications

    PREFERRED QUALIFICATIONS:

    • Bachelor’s degree preferred

     

    PHYSICAL/MENTAL DEMANDS AND WORKING ENVIRONMENT:

    The physical and mental requirements along with the work environment characteristics described here are representative of those an individual encounters while performing the essential functions of this position.

    Office: While performing the essential functions of this job the employee is frequently required to reach, grasp, stand and/or sit for long periods of time (up to 90% of the shift), walk, talk and hear; occasionally required to lift and/or move up to 25 pounds. The noise level in the work environment is usually moderately quiet, with frequent interruptions and multiple demands.

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