Specialty Pharmacy Liaison

About the role

Responsible for improving patient outcomes by assisting with processing, filling, and delivery of medications. This position leads and manages referrals, verifies patient demographics and medication coverage, and initiates prior authorization requests. This role facilitates patient assistance, appeals, peer reviews, and co-pay assistance, ensuring communication with specialty patients and referral sources.

Responsibilities

• Develops content and presents clinical services to provider offices
• Provides metrics related to prior authorization and patient funding success rates
• Maintains accurate and up-to-date patient records and documentation
• Dispenses medications accurately and efficiently to patients
• Reviews and verifies prescriptions for accuracy and completeness
• Manages inventory to ensure adequate stock levels and compliance with regulations
• Utilizes patient assistance programs to provide financial aid to eligible patients
• Participates in quality improvement initiatives to enhance pharmacy services
• Monitors patient medication adherence and provides interventions as needed
• Other duties as assigned

Requirements

• Proficiency with prescription-filling software and other computer skills
• Proficient in processing third party claims and secondary billing
• Knowledge of part B and part D Medicare billing
• Knowledgeable in most major prescription insurance carrier reimbursement guidelines and eligibility for coverage by third-party payers
• Knowledge of medical terminology and vast understanding of mathematical principles to perform pharmaceutical calculations
• Associate's degree OR High School Grad and 5+ years of experience
• Licenses and certifications: Registered Pharmacy Technician (RPhT), Certified Pharmacy Technician (CPhT)

Qualifications

• 5+ years working in a retail pharmacy or equivalent environment
• Previous experience in a managed healthcare organization, medical insurance company, pharmacy benefit management or other healthcare related entity
• Prior experience facilitating prior authorizations, patient assistance and co-pay assistance
• Prior experience processing and filling prescriptions for specialty patients

Skills

• Proficiency with prescription-filling software and other computer skills
• Proficient in processing third party claims and secondary billing
• Knowledge of part B and part D Medicare billing
• Knowledgeable in most major prescription insurance carrier reimbursement guidelines and eligibility for coverage by third-party payers
• Knowledge of medical terminology and vast understanding of mathematical principles to perform pharmaceutical calculations

Benefits

Extensive benefits package including medical, dental, vision insurance, life insurance, disability insurance, paid time off, 403-B retirement plan, whole person well-being resources, mental health resources and support, pet benefits, career development, and more.

Schedule

M-F, 8A-8P with possibility for some weekends (Flexible); 40 hours/week

Pay

$20.38 - $32.60