Patient Financial Advocate-FCP

Overview

MHealth Fairview is hiring a Patient Financial Advocate for our Kasota offices located in Minneapolis! This eligible position is a 1.0FTE on the day shift!

In this role, you will serve as a pharmacy financial advocate for patients. Your primary focus will be coordinating access to specialty take home medications.

Using superior customer service skills, you will proactively investigate specialty patient coverage benefits and financial assistance to facilitate access to specialty medication and promote compliance.

Be the expert problem solver and resource for resolving issues and questions from internal and external departments. Build and employ knowledge of funding resources to provide the highest level of assistance available.

Be available to train new employees and cross train to maintain specialty knowledge and support team members. Track and analyze metrics as directed.

Responsibilities Job Description

Educate patients on their insurance prescription benefits coverage, medical when applicable

Expediting patient access to specialty medications by identifying and resolving barriers, including submitting and following prior authorizations, supporting providers by assisting with appeals, coordinating fulfillment of orders with dispensing pharmacies, and assisting patients in being able to financially afford their medications

Provide exceptional service, act as a resource for patients and other customers, and guide them through the prescription ordering and payment processes

Contact insurance carriers, benefits offices, and patients to determine benefit breakdown information, including new and ongoing eligibility status

Utilize various computer systems used by the pharmacy to effectively complete required tasks and communication with patients

Utilize established protocols for communication of benefit investigation and insurance outcomes and become an expert in the management of patient benefits for various payers and various therapeutic disease states

Understand the patient journey, support resources available, and strategies to shape ongoing patient relationships

Assess all billing claims and investigate available third-party and / or supplementary resources for drug costs.

Aid patients in obtaining financial assistance (copay cards, grants, foundations). Coordination of care with other teams to provide financial assistance.

Manage and follow-up on patient A / R accounts, patient outreach for payments as necessary

Improve processes to facilitate communication and service between patients, providers, and pharmacy teams to ensure accurate and timely delivery of all take-home medications.

Communicate benefits investigation and prior authorization determinations to meet both internal and external clinic specifications and channels

Qualifications

Credentials :

The ideal candidate will have experience in pharmacy, working with specialty medications, prior authorizations, and / or coordinating work with multiple stakeholders.

Communication skills, interpersonal skills, adaptability are critical. A willingness to work in a fast-paced environment, work independently, to grow and develop, and to be an integral part of the team is necessary.

Required

Education

Baccalaureate degree in business or healthcare related field or equivalent combination of education and related experience.

Experience

Two years of pharmacy technician experience

License / Certification / Registration

Registered as Pharmacy Technician with the MN State Board of Pharmacy. If Minnesota Board of Pharmacy registration on or after 1 / 1 / 2013, must have a certificate of completion from a MNBOP approved employer based or vocational / technical training program

National Technician Certification within 6 months of hire.

Additional Requirements : Demonstrated knowledge of government and third-party insurance products, regulatory requirements, contract provision and provider agreements.

Pharmacy knowledge helpful. Excellent communication skills. Proficient in the English language. Proficient math skills. Proficiency with PC software and A / R systems essential including basic typing skills.

Ability to work in a team-based environment. Ability to maintain an environment of honest and confidential communications.

Ability to communicate as needed, both written and verbal information in a clear, concise, accurate and considerate manner.

Ability to deal professionally, courteously, and efficiently and to remain calm under stress. Ability to assess and clarify changing priorities.

Proven ability to problem-solve effectively.