Job Description

Job Title: Hub Reimbursement Specialist & Patient Care Coordinator

Reports to: Program Manager

FLSA Status: Non-exempt

Duties and Responsibilities include but are not limited to the following:

• Triage all incoming phone calls, faxes, and referrals
• Call insurance plans to follow-up on submitted prior authorizations, when applicable
• Communicate to the staff and then escalate to the Program Manager for any unresolved issues
• Proactively monitor program for possible issues before prescription abandonment
• Follow all applicable government regulations including HIPAA

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Skills:

• Knowledge of pharmacy claims adjudication process
• Accurate data entry
• High level of customer service and empathy
• Experience with PC and Microsoft Word and Excel required
• Strong third-party managed care knowledge
• Excellent written and oral communication skills along with problem solving skills required
• Ability to problem solve under pressure
• Attention to Detail
• Organization and Time Management Skills
• Decision Making and Judgment
• Accountability and Dependability
• Ethics and Integrity
• Relationship Building

Education/Experience:

• Valid and current national pharmacy technician licensed issued by the Pharmacy Technician Certification Board (PTCB) preferred
• 2 years of experience in a prior pharmacy hub setting preferred

Computer Skills:

To perform this job successfully, an individual should have working knowledge of:

• Microsoft Office (Excel, Word, PowerPoint, etc.)

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