Overview

 

YOUR PASSION, ACTIONS & FOCUS is our Strength

Become one of our Contributors

Join the Caretria Team!

 

The Pharmacy Patient Advocate supports the enrollment process and patients in accessing coverage for their prescribed medications through inbound and outbound telephone support, as well as administrative functions.

Responsibilities

KEY RESPONSIBILITIES:

• Review and process patients’ enrollment forms to the Patient Assistance Program (PAP)
• Assist patients on the phone with PAP program enrollment by verifying the pre-screening and qualifying tasks.
• Notify patients and healthcare providers of approvals, denials, and any next steps needed to continue the enrollment process
• Schedule treatments to be sent to the patient or patient’s healthcare provider
• Support inbound and outbound phone lines for the PAP program
• Communicate daily with patient/authorized representatives on eligibility based on PAP criteria and healthcare providers to manage expectations.
• Contact patient/authorized representative to determine supplementary information needed to enroll into the manufacturer’s PAP program.
• Prioritize workload to ensure patients’ enrollments are processed within specified timeframe
• Explain the PAP program and services to patients, authorized representatives, healthcare providers and physician office staff.
• Respond to program inquiries from patients, authorized representatives, healthcare providers, patient advocates, and caregivers.
• Report adverse events/product complaint inquires received in accordance with standard operating procedures and current good manufacturer practices.
• Execute day-to-day operations specific to the assigned program(s).
• Always maintain patient confidentiality.

The above duties are meant to be representative of the position and not all inclusive.

Qualifications

MINIMUM JOB REQUIREMENTS:

• High school diploma or equivalent
• Kentucky Pharmacy Technician Registration
  • Kentucky requires a licensed pharmacy technician to be over the age of 18.

 

• Two (2) years of work experience in customer service or customer focused healthcare role
• One (1) year of work experience in a HUB service or call center environment.
• Strong attention to detail and accuracy in data entry
• Experience with insurance and benefit investigations; knowledge of U.S. Private and Government payers
• Must have proven ability to provide consistently high-quality of service

 

PREFERRED EDUCATION AND EXPERIENCE:

• Education: Associate degree or completion of technical school training in healthcare, pharmacy or a related field
• Experience:
  • Two (2) years of work experience in pharmacy, managed care, Medicaid and/or Medicare organizations, pharmaceutical and/or biotech manufacturer, insurance, medical office, or related field
  • Experience with HIPAA regulations and privacy standards
• Certifications:

National Pharmacy Certification (PTCB, ExCPT) preferred

• Language Skills:
  • Bilingual proficiency in English and Spanish strongly preferred
• Prior experience in patient assistance programs and/or benefit verification processes

KNOWLEDGE, SKILLS & ABILITIES:

• Demonstrated empathy and compassion
• Excellent verbal and written communication skills
• Excellent organization skills and detail oriented
• Balance multiple priorities to meet expected response deadlines
• Adaptable, flexible and readily adjust to changing situations
• Ability to work independently and as a member of a team
• Ability to comprehend and apply basic math principles
• Ability to apply logical thinking when evaluating practical problems
• Ability to present information and respond to questions from stakeholders
• Ability to interact with a diverse group
• Ability to listen and demonstrate a high degree of empathy
• Demonstrated computer skills includes Microsoft Word, Excel, and Outlook
• Display tact and diplomacy in response to unfavorable or negative situations
• Demonstrated sensitivity and understanding when speaking with patients
• Demonstrated passion for speaking with people in an outgoing way

PHYSICAL REQUIREMENTS:

• Location of job activities Remote, Hybrid or onsite; geographic location
• Extensive manual dexterity (keyboarding, mouse, phone)
• Constant use of phone for communication
• Noise and/or vibrations exposure
• Frequently reach (overhead), handle, and feel with hands and arms
• Sit for prolonged periods of time
• Occasionally stoop, kneel, and crouch
• Occasionally lift, carry, and move up to 25 pounds

 

 

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