Riverside Health System
Healthcare
SpecialtyMedicationCoordinator
Neural analysis suggests this role is
optimal for Mid+ candidates.
“Specialty Medication Coordinator at Riverside Health System. Skills: Prior authorizations, Patient assistance, Medication management. Process referrals. Submit clinical supporting documentation”
Industry & Context.
What They're Looking For.
Must Have
Program Graduate, Licensed Practical Nurse, Program Graduate, Certified Medical Assistant, 3-4 years Experience as a Pharmacy Technician, LPN or CMA, Registered Pharmacy Technician - Virginia Department of Health Professions Upon Hire, Pharmacy Technician Certification Board (PTCB) - Pharmacy Technician Certification Board (PTCB) PTCB or ExCPT Upon Hire, Licensed Practical Nurse (LPN) - Virginia Department of Health Professions Upon Hire, Certified Medical Assistant (CMA) - American Association of Medical Assistants Upon Hire
Nice to Have
Program Graduate, Pharmacy Technician Training Program, 1 year Experience obtaining and managing medication prior authorization, 1 year Prior Experience obtaining and managing patient assistance program applications, Advanced certification in specialty pharmacy field
What You'll Do.
Submit clinical supporting documentation
Expedite prior authorization
Expedite patient assistance processes
Assist in obtaining prior authorizations
Assist in obtaining patient assistance medications
Assist in obtaining financial assistance
Assist with medical necessity documentation
Perform appropriate follow-up
Follow prior authorization workflows
Follow patient assistance workflows
Follow policies and procedures
Perform tasks accurately
Perform tasks efficiently
Respond to key stakeholders
Document intake referrals
Document prior authorization information
Maintain up to date knowledge
Track and manage patient refills
Ensure timely prescription
Ensure timely infusion service
Work on prior authorization enrollments
Work on patient assistance enrollments
Secure patients’ demographic information
Secure patients’ medical information
Comply with HIPAA policies
Assist management with inspections
Assist management with audits
Assist management with reports
Assist management with training
Ensure compliance with standards
Provide quality service
How You'll Work.
Team & Collaboration
Collaborate with other departments
Communication Scope
Written communication; Verbal communication
Full Job Description
Newport News, Virginia **Overview** A Specialty Medication Coordinator is responsible for performing tasks related to the management of third-party billing or patient financial assistance for patients within the health system. A Specialty Medication Coordinator assists with managing and processing high dollar specialty medications (e.g. oncology, infectious disease, multiple sclerosis) and may be responsible for benefits investigation, obtaining prior authorizations, copay/foundation assistance, drug replacement services, and patient financial counseling. Additional activities may include patient onboarding, order entry, financial tracking, patient care coordination, medication ordering/tracking, cold chain distribution and shipping activities. **What you will do** * Timely process of referrals and submit clinical supporting documentation to insurance carriers, manufacturers, or foundations to expedite prior authorization and/or patient assistance processes. Collaborate with other departments to assist in obtaining prior authorizations, patient assistance medications or financial assistance. Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed. Follows prior authorization and/or patient assistance workflows and policies/procedures. * Demonstrates the ability to work independently, meet deadlines and possesses excellent time management skills. Perform tasks accurately and efficiently. Possesses excellent interpersonal, customer service and communication skills (both written and verbal); timely responses to key stakeholders. * Accurate documentation of all intake referrals and/or prior authorization information in patient medical record or patient assistance tracking software in compliance with policy and procedure/workflow. Completes timely documentation within the required tracking systems and retrieves necessary documentation and maintains up to date knowledge of the pharmaceutical companies’ patient a
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