Summit Health Pharmacy is a compounding and specialty pharmacy dedicated to providing the highest quality of customized medication to patients, providers and other organizations across the entire healthcare continuum.
Primary Responsibilities:
Communicates with third-party payers and providers regarding initial and concurrent clinical review. Helps to support the appeal process to overturn insurance denials and/or benefit exclusions. Enters authorizations into the appropriate system to ensure accurate claims processing. Interacts with providers to gain additional clinical information regarding their prescription order. Performs initial and follow-up phone assessment of rare disease patients. Handles outbound and inbound calls to/from patients, office staff and prescribers. Provides clinical support to medication-related questions at Chemistry Rx. Assists with the establishment of clinical standards/processes. Ensures close coordination with pharmacists on patient clinical management. Represents the company in a professional manner and appearance at all times. Adheres to all company policies as indicated in the handbook and directives issued by management. Has reviewed Accreditation Policy and Procedure manual.
Professional Competencies:
Excellent written and verbal communication skills, effectively interacts with patients, co-workers, management and other healthcare professionals. Ability to exercise discretion and maintain confidentiality to level of required HIPAA standards.
Required Qualifications:
Prior experience in pediatrics, the treatment/care of patients with conditions that require specialty medications and/or experience in ambulatory care setting with background in obtaining prior authorizations for medications. Strong customer service skills. Proficient in Microsoft Word and Excel. Highly motivated, very passionate about patient care and providing access to treatment options, and significant interest in working in several different disease areas at the same time.
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person