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Specialty Pharmacy Patient Financial Advocate
The University of Kansas Health System. Act as a financial advocate for patients seeking access to specialty prescription medications .
About the role
Key responsibilities & impact- Act as a financial advocate for patients seeking access to specialty prescription medications
- Gather patient information and complete specialty prescription benefits investigations within specified time frames
- Interpret, comply with, and communicate Medicare/Medicaid rules and regulations when appropriate
- Ensure appropriate billing of specialty prescription medications and complete required insurance authorizations
- Follow up with insurance companies regarding denials and inquiries to resolve accounts
- Seek and apply for copay assistance and manufacturer free-drug programs
- Review patient financial documents and coordinate application materials
- Document activities in the electronic medical record
- Contact patients or caregivers by phone or electronically regarding prescription coverage and financial information
- Explain delays, required information, and actions needed to fill prescriptions
- Communicate with pharmacists and clinic staff to resolve insurance and prescription access issues
- Resolve patient billing questions and complaints
- Resolve denials, insurance changes, claims, and account issues
- Participate in continuous improvement and departmental process improvements
- Assist with training new team members as requested
- Process statements, payments, refunds, and adjustments through the point-of-sale system
- Review monthly reports, data, and trends and communicate improvement opportunities to leadership
Requirements
What you’ll need- High School Graduate plus 3 years of experience in specialty pharmacy, medication assistance, prior authorizations, pharmacy benefits investigation, managed care, financial advising, claims processing, collections, or revenue cycle positions; OR Associate Degree in a related field from an accredited college or university plus 1 year of relevant experience
- Kansas Pharmacy Technician registration within 60 days of hire, including application with the state board of pharmacy
- Must be able to type 45 wpm
- Strong oral and written communication skills
- Ability to multitask, prioritize, and escalate
- Knowledge of commercial and government insurance
- Ability to navigate payer websites
- Working knowledge of CMS regulations applicable to Medicare Part B and D plans
- Epic experience
- Customer service experience
Benefits
Comp & perks- PRN employment arrangement
- Hybrid work arrangement
- Equal employment opportunity
- Reasonable accommodations for qualified individuals with disabilities