JOB DESCRIPTION
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.
RESPONSIBILITIES
- 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
- 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
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- 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
QUALIFICATIONS
Minimum
- High School Diploma or GED
- 1 year of proven work experience in a healthcare or customer service industry
- Superior telephone customer service skills
- Demonstrated strength in listening, oral and written communications in English
- Excellent data management software skills with demonstrated adaptability to internal systems
- Demonstrated ability to manage a range of priorities and meet time commitments
- Excellent knowledge of insurance benefit investigation process and techniques
- Strong organization skills as well as attention to detail
Desired
- Any additional training in pharmacy/medical benefit access and requirements
- Any previous experience in a call center preferred where performance was measured
- Any healthcare experience with a basic understanding of clinical terms and benefits investigation
ABOUT US
\n From one tiny Cincinnati grocery store more than a century ago, we've grown into what today is the nation's largest grocer with nearly 2,800 stores in 35 states operating under 28 different names. As America's grocer, we take pride in bringing diverse teams with a passion for food and people together with one common purpose: To Feed the Human Spirit. With a history of innovation, we work tirelessly to create amazing experiences for our customers, communities AND each other, with food at the heart of it all. \n
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\n Here, people matter. That's why we strive to provide the ingredients you need to create your own recipe for success at work and in life. We help feed your future by providing the value and care you need to grow. If you're caring, purpose-driven and hungry to learn, your potential is unlimited. \n
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\n Whether you're seeking a part-time position or a new career path, we've got a fresh opportunity for you. Apply today to become part of our Kroger family! \n