Care Navigator
Company DescriptionJob Description
Job Description:
The Care Navigator - Rare/Orphan will be responsible for supporting the pharmacist in end-to-end prescription processing, including order intake, benefits investigation, prior authorization support, Rx setup and claims adjudication, as well as refill management and delivery coordination functions in accordance with company policies and procedures.
Responsibilities:
Enter new patient and provider information accurately into the pharmacy MIS.
Review contents of referrals to ensure complete and accurate information has been received and entered into the pharmacy system.
Communicate with providers to obtain missing information when necessary.
Locate and enter accurate prescription insurance information on patient's profile by processing eligibility checks and adjudicating pharmacy claims.
Adjudicate claims and troubleshoot rejections so that the correct information is communicated to the patientCommunicate the need for medication prior authorization (PA) to providers and serve as a resource to the provider during the PA process.
Manage inbound calls from patients, clients, physicians, practitioners and clinics regarding inquiries about order status, services provided, financial support optionsServe as a technical resource pertaining to adjudication while identifying areas for improvement.
Entering detailed, accurate, and grammatically correct progress notes to ensure proper documentation on patient profiles.
Contact patients to schedule medication delivery and payment so that accurate information is included in their profile and distribution can successfully send their package in a timely mannerManage patient refill coordination and follow-up to ensure patients comply with their therapy planIdentify and report adverse events (AEs) and product complaints (PCs) to clinicians to ensure patient's safetyPerform other duties as assigned (above tasks may vary slightly depending on the specific team/program requirements.
)QualificationsShift Details:
Monday - Friday 9:
00 am - 6:
00 pmMinimum Requirements:
CPhT (Certified Pharmacy Technician) certification preferred.
Must be current, without restrictions, and in good standing5
years prior experience working in a pharmacy or other health care setting requiredCritical Requirements:
Experience with insurance eligibility and prior authorization processesCompetent in basic computer skills and proficiency in Microsoft applicationsConscientious, detail oriented with the ability and desire to solve problems to help our patientsFlexible, adaptable, and the ability to effectively work in a team setting to accomplish a common goalHighly motivated and committed to excellence with a positive attitudeCareer Level - IC - Business Support - B4Additional InformationAll your information will be kept confidential according to EEO guidelines.
Recommended Skills Adaptability Attention To Detail Claim Processing Finance Hardworking And Dedicated Microsoft Softwares Estimated Salary: $20 to $28 per hour based on qualifications.
Job Description:
The Care Navigator - Rare/Orphan will be responsible for supporting the pharmacist in end-to-end prescription processing, including order intake, benefits investigation, prior authorization support, Rx setup and claims adjudication, as well as refill management and delivery coordination functions in accordance with company policies and procedures.
Responsibilities:
Enter new patient and provider information accurately into the pharmacy MIS.
Review contents of referrals to ensure complete and accurate information has been received and entered into the pharmacy system.
Communicate with providers to obtain missing information when necessary.
Locate and enter accurate prescription insurance information on patient's profile by processing eligibility checks and adjudicating pharmacy claims.
Adjudicate claims and troubleshoot rejections so that the correct information is communicated to the patientCommunicate the need for medication prior authorization (PA) to providers and serve as a resource to the provider during the PA process.
Manage inbound calls from patients, clients, physicians, practitioners and clinics regarding inquiries about order status, services provided, financial support optionsServe as a technical resource pertaining to adjudication while identifying areas for improvement.
Entering detailed, accurate, and grammatically correct progress notes to ensure proper documentation on patient profiles.
Contact patients to schedule medication delivery and payment so that accurate information is included in their profile and distribution can successfully send their package in a timely mannerManage patient refill coordination and follow-up to ensure patients comply with their therapy planIdentify and report adverse events (AEs) and product complaints (PCs) to clinicians to ensure patient's safetyPerform other duties as assigned (above tasks may vary slightly depending on the specific team/program requirements.
)QualificationsShift Details:
Monday - Friday 9:
00 am - 6:
00 pmMinimum Requirements:
CPhT (Certified Pharmacy Technician) certification preferred.
Must be current, without restrictions, and in good standing5
years prior experience working in a pharmacy or other health care setting requiredCritical Requirements:
Experience with insurance eligibility and prior authorization processesCompetent in basic computer skills and proficiency in Microsoft applicationsConscientious, detail oriented with the ability and desire to solve problems to help our patientsFlexible, adaptable, and the ability to effectively work in a team setting to accomplish a common goalHighly motivated and committed to excellence with a positive attitudeCareer Level - IC - Business Support - B4Additional InformationAll your information will be kept confidential according to EEO guidelines.
Recommended Skills Adaptability Attention To Detail Claim Processing Finance Hardworking And Dedicated Microsoft Softwares Estimated Salary: $20 to $28 per hour based on qualifications.
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