Pharmacy Patient Advocate

Overview

YOUR PASSION, ACTIONS & FOCUS is our Strength

Become one of our Contributors

Join the Caretria Team!

The Pharmacy Patient Advocate supports the enrollment process and patients in accessing coverage for their prescribed medications through inbound and outbound telephone support, as well as administrative functions.

Responsibilities

Review and process patients’ enrollment forms to the Patient Assistance Program (PAP)

Assist patients on the phone with PAP program enrollment by verifying the pre-screening and qualifying tasks.

Notify patients and healthcare providers of approvals, denials, and any next steps needed to continue the enrollment process

Schedule treatments to be sent to the patient or patient’s healthcare provider

Support inbound and outbound phone lines for the PAP program

Communicate daily with patient/authorized representatives on eligibility based on PAP criteria and healthcare providers to manage expectations.

Contact patient/authorized representative to determine supplementary information needed to enroll into the manufacturer’s PAP program.

Prioritize workload to ensure patients’ enrollments are processed within specified timeframe

Explain the PAP program and services to patients, authorized representatives, healthcare providers and physician office staff.

Respond to program inquiries from patients, authorized representatives, healthcare providers, patient advocates, and caregivers.

Report adverse events/product complaint inquires received in accordance with standard operating procedures and current good manufacturer practices.

Execute day-to-day operations specific to the assigned program(s).

Always maintain patient confidentiality.

The above duties are meant to be representative of the position and not all inclusive.

Qualifications

MINIMUM JOB REQUIREMENTS:

High school diploma or equivalent

Kentucky Pharmacy Technician Registration

Kentucky requires a licensed pharmacy technician to be over the age of 18.

Two (2) years of work experience in customer service or customer focused healthcare role

One (1) year of work experience in a HUB service or call center environment.

Strong attention to detail and accuracy in data entry

Experience with insurance and benefit investigations; knowledge of U.S. Private and Government payers

Must have proven ability to provide consistently high-quality of service

PREFERRED EDUCATION AND EXPERIENCE:

Education: Associate degree or completion of technical school training in healthcare, pharmacy or a related field

Experience:

Two (2) years of work experience in pharmacy, managed care, Medicaid and/or Medicare organizations, pharmaceutical and/or biotech manufacturer, insurance, medical office, or related field

Experience with HIPAA regulations and privacy standards Certifications:

National Pharmacy Certification (PTCB, ExCPT) preferred

Language Skills:

Bilingual proficiency in English and Spanish strongly preferred

Prior experience in patient assistance programs and/or benefit verification processes

KNOWLEDGE, SKILLS & ABILITIES:

Demonstrated empathy and compassion

Excellent verbal and written communication skills

Excellent organization skills and detail oriented

Balance multiple priorities to meet expected response deadlines

Adaptable, flexible and readily adjust to changing situations

Ability to work independently and as a member of a team

Ability to comprehend and apply basic math principles

Ability to apply logical thinking when evaluating practical problems

Ability to present information and respond to questions from stakeholders

Ability to interact with a diverse group

Ability to listen and demonstrate a high degree of empathy

Demonstrated computer skills includes Microsoft Word, Excel, and Outlook

Display tact and diplomacy in response to unfavorable or negative situations

Demonstrated sensitivity and understanding when speaking with patients

Demonstrated passion for speaking with people in an outgoing way

PHYSICAL REQUIREMENTS:

Location of job activities Remote, Hybrid or onsite; geographic location

Extensive manual dexterity (keyboarding, mouse, phone)

Constant use of phone for communication

Noise and/or vibrations exposure

Frequently reach (overhead), handle, and feel with hands and arms

Sit for prolonged periods of time

Occasionally stoop, kneel, and crouch

Occasionally lift, carry, and move up to 25 pounds

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.