Jefferson
Pharmacy Tech- Specialty Pharmacy Rep- King of Prussia
Jefferson, King Of Prussia, Pennsylvania, United States, 19406
Specialty Pharmacy Representative I
The Specialty Pharmacy Representative I drives our refill queues and assists patients, physicians, and pharmacists in the completion of claim adjudication/review, benefit investigations, financial assistance applications, refill/adherence activities, and other programs that drive optimal outcomes for Jefferson Specialty Pharmacy patients. Responsibilities include entering the patient information; name, date of birth, insurance information, allergies, and medication history into our therapy-specific patient assessment software. Assist with the filling and distribution of prescriptions, under the direction of a patient care pharmacist, in accordance with the law. Essential functions include: adjudicating and reviewing claims responses for reimbursement and profitability, analyzing claims messages to determine next steps for order escalation as needed, scheduling delivery of high dollar/specialty medications, assessing patient need for clinical intervention, identifying any barriers to care, non-compliance, changes in therapy/dosing, and escalating to the clinical support team when appropriate, reviewing patient chart to ensure all information is accurate and up to date, explaining insurance coverage to patients, screening patients for financial assistance, printing paperwork and filling prescriptions, tracking and monitoring deliveries, contributing to departmental Quality Assurance/Quality Improvement activities, and interacting with co-workers, visitors, and other staff consistent with the iSCORE values of Jefferson. Other functions and competencies include: acting as a liaison between the patient and their insurance company, foundations, and manufacturers, knowledge of commercial, Medicaid, and Medicare billing, demonstrated ability to listen skillfully, collect relevant information, and build relationship and trust with patients and providers, responding to customers in a compassionate manner, multi-tasking between several issues at one time, problem solving to serve patients, independently resolving complex customer conflicts, proactively documenting and recognizing cause and effect trends, knowledge and understanding of medical terminology, the Health Insurance Portability and Accountability Act, and principles and practices associated with the rights and responsibilities of patients and caregivers, knowledge of and ability to utilize software, technologies, and applications to interact with customers via a telephone, web, or other electronic means, knowledge of the major responsibilities, accountabilities, and overall organization of the customer support function or department, ability to properly support customer inquiries and bring problems to a timely resolution, knowledge of and ability to utilize practices, tools, and techniques for communicating with a customer. Educational/training requirements: High School Diploma or GED equivalent preferred. Certificates, licenses, and registration: AS/BS degree preferred; Certified Pharmacy Technician (CPhT) preferred. Experience requirements: 3+ years experience in customer service role 1+ years experience in a specialty pharmacy, hospital, health insurance company, benefits department or other related healthcare environment. Additional information: Proficient in the use of computers and Microsoft applications. Type 35 wpm. Critical thinking skills to solve problems and make informed thought out decisions; ability to learn from and lean on past experiences. Experience with clinical software systems; Specialty Medications and Medicare billing is highly preferred. Ability to communicate professionally and efficiently in both written and verbal format with patients, physicians, payors and clinical staff in-person and on the phone. Flexibility to adapt to changes in the departmental needs including but not limited to: offering assistance to other team members, adjusting assignments, etc. Detailed oriented with excellent organization skills, ability to learn quickly Ability to adapt in a dynamic work environment Demonstrated ability to handle difficult conversations in a professional and caring manner. Workday Day (United States of America) Worker Sub Type Regular Primary Location Address 3500 Horizon Drive, King of Prussia, Pennsylvania, United States of America Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical, and applied research. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years. Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status. At Jefferson, we offer a comprehensive total rewards package designed to support the health and well-being of our colleagues and their families. It includes a wide range of benefits including competitive pay, health and retirement benefits, life and disability insurance, paid time off, educational benefits, financial and mental health resources and much more. Our diverse benefits offerings ensure you have the coverage and access to services you need to thrive both personally and professionally.
The Specialty Pharmacy Representative I drives our refill queues and assists patients, physicians, and pharmacists in the completion of claim adjudication/review, benefit investigations, financial assistance applications, refill/adherence activities, and other programs that drive optimal outcomes for Jefferson Specialty Pharmacy patients. Responsibilities include entering the patient information; name, date of birth, insurance information, allergies, and medication history into our therapy-specific patient assessment software. Assist with the filling and distribution of prescriptions, under the direction of a patient care pharmacist, in accordance with the law. Essential functions include: adjudicating and reviewing claims responses for reimbursement and profitability, analyzing claims messages to determine next steps for order escalation as needed, scheduling delivery of high dollar/specialty medications, assessing patient need for clinical intervention, identifying any barriers to care, non-compliance, changes in therapy/dosing, and escalating to the clinical support team when appropriate, reviewing patient chart to ensure all information is accurate and up to date, explaining insurance coverage to patients, screening patients for financial assistance, printing paperwork and filling prescriptions, tracking and monitoring deliveries, contributing to departmental Quality Assurance/Quality Improvement activities, and interacting with co-workers, visitors, and other staff consistent with the iSCORE values of Jefferson. Other functions and competencies include: acting as a liaison between the patient and their insurance company, foundations, and manufacturers, knowledge of commercial, Medicaid, and Medicare billing, demonstrated ability to listen skillfully, collect relevant information, and build relationship and trust with patients and providers, responding to customers in a compassionate manner, multi-tasking between several issues at one time, problem solving to serve patients, independently resolving complex customer conflicts, proactively documenting and recognizing cause and effect trends, knowledge and understanding of medical terminology, the Health Insurance Portability and Accountability Act, and principles and practices associated with the rights and responsibilities of patients and caregivers, knowledge of and ability to utilize software, technologies, and applications to interact with customers via a telephone, web, or other electronic means, knowledge of the major responsibilities, accountabilities, and overall organization of the customer support function or department, ability to properly support customer inquiries and bring problems to a timely resolution, knowledge of and ability to utilize practices, tools, and techniques for communicating with a customer. Educational/training requirements: High School Diploma or GED equivalent preferred. Certificates, licenses, and registration: AS/BS degree preferred; Certified Pharmacy Technician (CPhT) preferred. Experience requirements: 3+ years experience in customer service role 1+ years experience in a specialty pharmacy, hospital, health insurance company, benefits department or other related healthcare environment. Additional information: Proficient in the use of computers and Microsoft applications. Type 35 wpm. Critical thinking skills to solve problems and make informed thought out decisions; ability to learn from and lean on past experiences. Experience with clinical software systems; Specialty Medications and Medicare billing is highly preferred. Ability to communicate professionally and efficiently in both written and verbal format with patients, physicians, payors and clinical staff in-person and on the phone. Flexibility to adapt to changes in the departmental needs including but not limited to: offering assistance to other team members, adjusting assignments, etc. Detailed oriented with excellent organization skills, ability to learn quickly Ability to adapt in a dynamic work environment Demonstrated ability to handle difficult conversations in a professional and caring manner. Workday Day (United States of America) Worker Sub Type Regular Primary Location Address 3500 Horizon Drive, King of Prussia, Pennsylvania, United States of America Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical, and applied research. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years. Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status. At Jefferson, we offer a comprehensive total rewards package designed to support the health and well-being of our colleagues and their families. It includes a wide range of benefits including competitive pay, health and retirement benefits, life and disability insurance, paid time off, educational benefits, financial and mental health resources and much more. Our diverse benefits offerings ensure you have the coverage and access to services you need to thrive both personally and professionally.