KY - Patient Advocate Pharmacy

POSITION SUMMARY

The 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 representative 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 a specified timeframe
• Explain the PAP program and services to patients, authorized representatives, healthcare providers and physician’s office staff.
• Respond to program inquiries from patients, authorized representatives, healthcare providers, patient advocates and caregivers.
• Report adverse events/product complaint inquiries received in accordance with standard operating procedures and current good manufacturing practices.
• Execute day-to-day operations specific to the assigned program(s).
• Maintain patient confidentiality at all times.

REQUIRED EDUCATION AND EXPERIENCE:

• High school diploma or equivalent
• Two (2) years of work experience in a customer service or customer focused role
• One (1) year of work experience in a call center environment.
• Experience with insurance and benefit investigations; knowledge of U.S. Private and Government payers
• Must have proven ability to provide consistently high-quality service

PREFERRED EDUCATION AND EXPERIENCE: 

• Associate Degree or technical school training in a related field
• 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 and patient services
• Bi-lingual, English, and Spanish

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 including 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 100% inside
• Extensive manual dexterity (keyboarding, mouse, phone)
• Constant use of the 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