Job Description

Newport News, Virginia

The Patient Assistance Program Coordinator is the subject matter expert in performing tasks related to the management of third-party billing or patient financial assistance for patient within the health system and assists with managing and processing high dollar specialty medications and may be responsible for benefits investigation, obtaining prior authorizations, copay/foundation assistance, drug replacement services and patient financial counseling. Additional activities may include patient onboarding, order entry, financial tracking, patient care coordination, medication ordering/tracking, cold chain distribution and shipping activities. This role will assist with training/onboarding of new employees and continually seeks growth through education opportunities and is a liaison to disseminate learned information.

What you will do

• Timely process of referrals and submit clinical supporting documentation to insurance carriers, manufacturers or foundations to expedite prior authorization and/or patient assistance processes. Collaborate with other departments to assist in obtaining prior authorizations, patient assistance medications or financial assistance. Assist with medical necessity documentations to expedite approvals and ensure that appropriate follow-up is performed. Follow prior authorization and/or patient assistance workflows and polices/procedures. Serves as a subject matter expert in the role and acts as a resources to other team members. Continually seeks growth educational opportunities and serves as a liaison to disseminate learned information.
• Demonstrates the ability to work independently, prioritize workflow to meet deadlines and possesses excellent time management skills. Perform tasks accurately and efficiently. Possesses excellent interpersonal customer service and communication skills (both written and verbal). Provides timely information, follow-up and responses to key stakeholders.
• Accurate documentation of all intake referrals and /or prior authorization information in the patient medical record or patient assistance tracking software in compliance with policy and procedure/workflow. Completes timely documentation within the required tracking systems and retrieves necessary documentation and maintains up to date knowledge of the pharmaceutical companies patient assistance programs.
• Proactively tracks and manages patient refills/outreach to ensure timely prescription/infusion services.
• Provides oversight and monitoring of prior authorizations and patient assistance enrollments to ensure continuation of treatment programs or drug access services.
• Secure patients' demographic and medical information in compliance with organization HIPAA policies and procedures.
• Proactively conducts inspections and audits to ensure program compliance. Provide timely, accurate reports and training to to demonstrate compliance with standards and to provide quality service.

Qualifications

Education

• Program Graduate, Pharmacy Technician Training Program or equivalent (Required) or
• Program Graduate, Licensed Practical Nurse (LPN) (Required) or
• Program Graduate, Certified Medical Assistant (CMA) (Required)

Experience

• 5-6 years Experience as Pharmacy Technician, LPN, or CMA (Required)
• 3-4 years Experience obtaining and managing medication prior authorization or medication assistance programs as part of job function (Required)

Skills and Abilities

• Microsoft Office (Excel, Word, Outlook)
• Familiar with Pharmacy and Medication Terminology
• Prescription drug and over-the-counter knowledge
• Basic math skills, including pharmaceutical calculations
• Basic pharmacy workflow
• Understanding pharmacy computer systems
• Ability to navigate and read electronic health records
• Knowledge of patient assistance programs
• Prior authorization of medications

Licenses and Certifications

• Registered Pharmacy Technician - Virginia Department of Health Professions (VDHP) Licensed Pharmacy Technician Upon Hire(Required) and
• Pharmacy Technician (CPHT) - Pharmacy Technician Certification Board (PTCB) Upon Hire(Required) or
• Licensed Practical Nurse (LPN) - Virginia Department of Health Professions (VDHP) Upon Hire(Required) or
• Certified Medical Assistant (CMA) - American Association of Medical Assistants (AAMA) Upon Hire(Required)
• Advanced certification in specialty pharmacy (Pharmacy Technician Certification Board, American Society Health System Pharmacy, National Community Oncology Dispensing Association or other approved programs) (Preferred)

To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers