Specialty Pharm Rep

Responsibilities

• Enter patient information into therapy-specific patient assessment software.
• Affix prescriptions under the supervision of a patient care pharmacist.
• Adjudicate and review claims responses for reimbursement and profitability.
• Analyze claims messages to determine next steps for order escalation.
• Schedule delivery of high-dollar/specialty medications and other maintenance medications.
• Assess patient need for clinical intervention based on refill questions or provided information.
• Identify barriers to care, non-compliance, and changes in therapy/dosing and escalate to the clinical support team.
• Review patient chart to ensure all information is accurate and up-to-date.
• Explain insurance coverage to patients regarding their copay responsibility and financial resources.
• Screen patients for financial assistance and apply on their behalf where applicable.
• Print paperwork and fill prescriptions under the supervision of a clinical pharmacist.
• Track and monitor deliveries to ensure medication arrives to patient undamaged; intervene where necessary to reship delivery.
• Contribute to departmental Quality Assurance/Quality Improvement activities.

Requirements

• High School Diploma or GED equivalent preferred.
• AS/BS degree preferred; Certified Pharmacy Technician (CPhT) preferred.
• 3+ years experience in customer service role.
• 1+ years experience in a specialty pharmacy, hospital, health insurance company, benefits department or other related healthcare environment.