Kroger – Patient Access Coordinator – M-F, 11- 8, WFH after training, Benefits Exp Preferred

Job title: Patient Access Coordinator – M-F, 11- 8, WFH after training, Benefits Exp Preferred

Company: Kroger

Job description: Job Description:

Company Name: Kroger Specialty Pharmacy

Position Type: Employee

FLSA Status: Non-Exempt

Position Summary

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.

Essential Job Functions * 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
Obtain prior authorizations; initiate requests, track progress, and expedite responses from insurance carriers and other payers, and maintain contact with customers to keep them continuously informed
Review for accuracy of prescribed treatment regimen prior to submission of authorization
Facilitate appeals process between the patient, physician and insurance company; compose clinical appeals letters based off of specific denial reason and patient’s clinical presentation and coordinate appointment of representative document
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
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

Minimum Position Qualifications * High School Diploma or GED

1 year of proven work experience in a healthcare or customer service industry
Superior telephone customer service skills
Strong organization skills as well as attention to detail
Excellent knowledge of insurance benefit investigation process and techniques
Demonstrated ability to manage a range of priorities and meet time commitments
Excellent data management software skills with demonstrated adaptability to internal systems
Demonstrated strength in listening, oral and written communications in English

Desired Previous Experience/Education * Pharmacy Technician Certification

Any additional training in pharmacy/medical benefit access and requirements
Any healthcare experience with a basic understanding of clinical terms and benefits investigation
Any previous experience in a call center preferred where performance was measured

Education Level: High School Diploma/ GED Required

Required Certifications/Licenses: None

Position Type: Full-Time

Shift(s): [[mfield4]]

Regions: Any

States: Florida

Keywords: Benefits Investigation, Prior Authorizations, Call Center, Healthcare, Insurance Verification

Other Jobs You May Be Interested In

Jobs at Kroger: At Kroger, we hire people who have a passion for helping others and who want to build a relationship with our Customers. No matter what stage of your career, you can build your future at Kroger. We look for people who want more, aspire to be more and work hard to achieve their goals. Our focus on keeping the Customer first is what makes us successful. We offer many opportunities not only in our stores, but in Manufacturing, Logistics, Marketing, Finance, Human Resources, and many other fields.

Company Overview: Kroger Family of Companies employs nearly half a million associates who serve over 11 million customers daily through a seamless shopping experience under a variety of . At The Kroger Co., we are Fresh for Everyoneâ„¢ and dedicated to our Purpose: To Feed the Human SpiritÂ®. We are committed to creating #ZeroHungerZeroWaste communities by 2025. Careers with The Kroger Co. and our family of companies offer competitive wages, flexible schedules, benefits and room for advancement.

Posting Notes: FL || Lake Mary || 3200 Lake Emma Drive || 32746 || Kroger Specialty Pharmacy || None || Health & Wellness; Call Center; Specialty Pharmacy || Employee || Non-Exempt || Full-Time || None

Kroger – Patient Access Coordinator – M-F, 11- 8, WFH after training, Benefits Exp Preferred – Lake Mary, FL

Other Jobs You May Be Interested In

Kroger – Patient Access Coordinator – M-F, 11- 8, WFH after training, Benefits Exp Preferred – Lake Mary, FL

Some Useful Important Links

Apply Now

Click Here

Interview

Question & Answers

Click Here

Create Free

Professional Resume

Click Here