Patient Access Coordinator- Benefits Exp-Required, Full Time, Great Benefits, M-F Hrs, Call Center

Kroger Lake Mary , FL 32795

Posted 3 weeks ago

Company Name: Kroger Specialty Pharmacy

Position Type: Employee

FLSA Status: N/A

Position Summary

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.

Essential Job Functions

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

Obtain prior authorizations; initiate requests, track progress, and expedite responses from insurance carriers and other payers, and maintain contact with customers to keep them continuously informed

Review for accuracy of prescribed treatment regimen prior to submission of authorization

Facilitate appeals process between the patient, physician and insurance company; compose clinical appeals letters based off of specific denial reason and patient's clinical presentation and coordinate appointment of representative document

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 Position Qualifications

High School Diploma or GED1 year of proven work experience in a healthcare or customer service industry

Superior telephone customer service skills

Strong organization skills as well as attention to detail

Excellent knowledge of insurance benefit investigation process and techniques

Demonstrated ability to manage a range of priorities and meet time commitments

Excellent data management software skills with demonstrated adaptability to internal systems

Demonstrated strength in listening, oral and written communications in English

Desired Previous Experience/Education

Pharmacy Technician CertificationAny additional training in pharmacy/medical benefit access and requirements

Any healthcare experience with a basic understanding of clinical terms and benefits investigation

Any previous experience in a call center preferred where performance was measured

Education Level: High School Diploma/ GED Required

Required Certifications/Licenses: None

Position Type: Full-Time

Shift(s): [[mfield4]]

Regions: Any

States: Florida

Keywords: PBM Benefits, Benefits, Prior Authorization, insurance claims, Medicare, Medicaid

Jobs at Kroger: At Kroger, we hire people who have a passion for helping others and who want to build a relationship with our Customers.

No matter what stage of your career, you can build your future at Kroger. We look for people who want more, aspire to be more and work hard to achieve their goals. Our focus on keeping the Customer first is what makes us successful. We offer many opportunities not only in our stores, but in Manufacturing, Logistics, Marketing, Finance, Human Resources, and many other fields.

Company Overview:
Kroger Family of Companies employs nearly half a million associates who serve over 11 million customers daily through a seamless shopping experience under a variety of banner names.

At The Kroger Co., we are Fresh for Everyone and dedicated to our Purpose: To Feed the Human Spirit. We are committed to creating #ZeroHungerZeroWaste communities by 2025. Careers with The Kroger Co. and our family of companies offer competitive wages, flexible schedules, benefits and room for advancement.

Posting Notes: FL || Lake Mary || 3200 Lake Emma Drive || 32746 || Kroger Specialty Pharmacy || None || Call Center; Insurance & Claims; Specialty Pharmacy || Employee || Non-Exempt || Full-Time || None



icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Pharmacy Technician MF Competitive Pay Excellent Benefits FL Rpht Required

Kroger

Posted 4 weeks ago

VIEW JOBS 5/19/2021 12:00:00 AM 2021-08-17T00:00 Company Name: Kroger Specialty Pharmacy Position Type: Employee FLSA Status: Non-Exempt Position Summary Perform duties to work under the guidance of a licensed registered pharmacist to maintain workflow and inventory in the pharmacy and prepare medications for patients, working within the limits of standard or accepted practice. Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion, and safety. Essential Job Functions Review and interpret physician medication orders and enter prescription data in preparation for pharmacist verificationPerform job assignments in full compliance and complete understanding of the state and federal laws and internal policies and procedures governing the handling, dispensing and distribution of prescription medicationsReceive and stock inventory of medications in keeping with inventory policy requirements; contribute to periodic inventory process, counting, and recording drugs and supplies on handSelect drugs from stock, count, package and accurately label prescriptions for pharmacist verification and shipmentProvide administrative Pharmacy support as assigned and assist in the training of new associates in the PharmacyCommunicate with all new patients informing them of prescription referral and welcoming them to Kroger Specialty Pharmacy (KSP)Respond to inbound Pharmacy calls, demonstrating customer service excellence, and triage to appropriate clinician or department; communicate with patients, prescribers' offices, and associates with a focus on patient careObtain patient's medication information for DUR investigationAdjudicate and review prescription insurance claims of medications to be deliveredContact insurance companies or other payers to complete prior authorization requirements, identify co-pay structure, and investigate coverage and benefitsProvide information and respond to requests to assist to obtain co-pay cards or financial assistance for patients, as applicablePerform or assist with any operations, as required to maintain workflow and to meet schedules and quality requirementsParticipate in any variety of meetings and work groups to integrate activities, communicate issues, obtain approvals, resolve problems and maintain specified level of knowledge pertaining to new developments, requirements, and policiesPerform other related duties as assignedMust be able to perform the essential job functions of this position with or without reasonable accommodation Minimum Position Qualifications High School Diploma or GEDPharmacy Technician CertificationAny additional specialized training in pharmacy/medical benefit access and requirementsConsistent focus and attention to detail resulting in superior accuracyExemplary communication skills, customer service, and customer relationship building skills; including listening, speaking, and writingDemonstrated organizational skillsClear and consistently demonstrated understanding of healthcare protocols for privacyDemonstrated proficiency with pharmacy applications (CPR+ preferred) and in operating computer with knowledge of office software including MS Word and Excel Desired Previous Experience/Education 1 year of healthcare customer service experience with knowledge of benefits access processesDemonstrated knowledge of medications utilized for therapy in the defined disease states served by the assigned pharmacy Education Level: High School Diploma/ GED Required Required Certifications/Licenses: Pharmacy Technician Certification Position Type: Full-Time Shift(s): [[mfield4]] Regions: Any States: Florida Keywords: Data Entry, Prescriptions, Verification, Specialty Pharmacy Jobs at Kroger: At Kroger, we hire people who have a passion for helping others and who want to build a relationship with our Customers. No matter what stage of your career, you can build your future at Kroger. We look for people who want more, aspire to be more and work hard to achieve their goals. Our focus on keeping the Customer first is what makes us successful. We offer many opportunities not only in our stores, but in Manufacturing, Logistics, Marketing, Finance, Human Resources, and many other fields. Company Overview: Kroger Family of Companies employs nearly half a million associates who serve over 11 million customers daily through a seamless shopping experience under a variety of banner names. At The Kroger Co., we are Fresh for Everyone™ and dedicated to our Purpose: To Feed the Human Spirit®. We are committed to creating #ZeroHungerZeroWaste communities by 2025. Careers with The Kroger Co. and our family of companies offer competitive wages, flexible schedules, benefits and room for advancement. Posting Notes: FL || Lake Mary || 3200 Lake Emma Drive || 32746 || Kroger Specialty Pharmacy || None || Health & Wellness; Pharmacy; Specialty Pharmacy || Employee || Non-Exempt || Full-Time || Pharmacy Technician Certification Kroger Lake Mary FL

Patient Access Coordinator- Benefits Exp-Required, Full Time, Great Benefits, M-F Hrs, Call Center

Kroger