Pharmacy Patient Care Coordinator

About the role

Positive Impact Health Centers (PIHC) is a community leader in providing HIV prevention, care and treatment services located in Metro Atlanta. The PIHC model of care assures that clients have access to medical, pharmacy, dental, behavioral health and social services, providing the best opportunity for patients to achieve high-quality health outcomes. Services are provided on-site and through telehealth.

Responsibilities

• Serve as PIHC Pharmacy liaison to assigned PIHC Clinic team to field questions related to patient medication access from patient, provider, or others involved in patient’s medication access.
• Establish self as primary internal and external liaison and subject matter expert for medication assistance through educational trainings.
• Screen, apply and coordinate application of medication assistance opportunities for patients.
• Enroll and coordinate necessary paperwork for manufacturer assistance programs, disease-based assistance programs, identifying co-pay assistance opportunities for underinsured patients and use of charity funds as appropriate, following PIHC Pharmacy’s Policies and Procedures.
• Absorb and coordinate the Prior Authorization process.
• Assists patient and prescribers with the Prior Authorization process.
• Coordinates billing and obtains cost approval.
• Troubleshoot rejected claims and eligibility investigation, thoroughly investigate status of claims, and works with processors on billing issues or retroactive billing as need, and ensure expedite claims processing.
• Proactively identify problematic third-party payor scenarios to minimize billing rejections, report trends or issues related to billing and reimbursement.
• Coverage of agency wide efforts to ensure access to prescription medications.
• Coordinate documentation to promote continuity of treatments, improve access to medications, decrease financial strain and serve as a resource for medication assistance-related questions.
• Contribute to policy changes, goal setting or making recommendations for improvements.
• Attend and conduct meetings as deemed appropriate by pharmacy management.
• Provides quality customer service to patients and other healthcare providers, with focus on professional discretion and HIPAA regulations.
• May be assigned additional process or quality improvement projects based on departmental need.

Requirements

• Able to function independently without close supervision when appropriate.
• Able to adapt to change in workflow/style.
• Proficient computer skills, word processing, documentation, and navigation of the internet.
• Excellent time management and research skills.
• Ability to problem solve and communicate effectively.
• Knowledge of Patient Assistance Programs (PAPs) and ability to navigate alternative sources of funding.
• High level of dedication to patient care and improving patient medication access.
• Clear understanding of and the ability to comply with the GA BOP Rules and Regulations.
• High level of attention to detail.
• Comfortable with addressing insurance rejections and prescription claims processing.
• Self-motivation and driven to succeed.

Qualifications

• Licensed pharmacy technician in good standing with the Georgia Board of Pharmacy.
• 2-4 years of pharmacy technician experience in a retail setting with experience with pharmacy insurance navigation and various medication assistance programs.

Skills

• Knowledge of Patient Assistance Programs (PAPs) and ability to navigate alternative sources of funding.

Benefits

• Competitive Salary & Benefits.
• Automatic 3% Safe Harbor & 2% Profit Sharing (Retirement Program).
• 100% allotted for benefit elections for employees, 50% allotted for benefit elections for employee's spouse/dependent.
• Credit Union.

Pay

$27.00 hourly.