Patient Access Coordinator - Remote After Training - Health Insurance Exp Preferred

October 9, 2024

Company: Kroger

Industry: Private

Employment Type:- Full Time

Work Hours:- 8 Hours

Locations:- USA

Full Job Description:-

Perform duties to assist patients with access to benefits and co-pay cards, and schedule delivery of prescriptions provided through the specialty pharmacy, working within the limits of standard or accepted practice. Demonstrate the company s core values of respect, honesty, integrity, diversity, inclusion, and safety. - Communicate with patients to obtain information required to process prescriptions, refills, access benefits and apply charges against co-pay cards

Investigate and verify benefits for pharmacy and medical third-party claims for assigned cases
Complete status check with insurance company regarding receipt/outcome of prior authorization and appeal; obtain approval information and activates copay cards based off of eligibility and specific drug prescribed
Track, report and escalate service issues arising from requests for authorizations, financial assistance or other issues that delay service
Notify patients when their prescription has been transferred and follow up with specialty pharmacy to confirm the prescription was received (in some jurisdictions)
Coordinate verbal transfer by a pharmacist if specialty pharmacy has no record of prescription (in some jurisdictions); confirm with patient that prescription was received from alternate specialty pharmacy
Complete a series of assessments mandated by either manufacturer contracts or operations and facilitates patient enrollment with manufacturer Hubs when required
Document case activity, communications and correspondence in computer system to ensure completeness and accuracy of patient contact records
Ensure that work activities are conducted in compliance with regulatory requirements and the organization s defined standards and procedures, and in a manner that provides the best available level of service and quality
Perform or assist with any operations, as required to maintain workflow and to meet business needs
Perform other related duties as assigned
Must be able to perform the essential job functions of this position with or without reasonable accommodation

Minimum

High School Diploma or GED
1 year of proven work experience in a healthcare or customer service industry
Superior telephone customer service skills
Demonstrated strength in listening, oral and written communications in English
Excellent data management software skills with demonstrated adaptability to internal systems
Demonstrated ability to manage a range of priorities and meet time commitments
Excellent knowledge of insurance benefit investigation process and techniques
Strong organization skills as well as attention to detail

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Desired

Any additional training in pharmacy/medical benefit access and requirements
Any previous experience in a call center preferred where performance was measured
Any healthcare experience with a basic understanding of clinical terms and benefits investigation