Specialty Pharmacy Care Coordinator

• Complete benefit investigations to verify patient eligibility for prescribed specialty medications
• Maintain current knowledge of payer formularies and reimbursement
• Support third-party prior authorization processes and obtain appropriate overrides
• Maintain accurate insurance information and monitor prior authorization renewal needs
• Triage patient or caregiver clinical questions, medication concerns, and insurance denials to the pharmacist
• Use the Electronic Health Record to maintain communication and accurate documentation
• Represent the pharmacy effectively throughout the organization
• Serve as the primary patient contact for specialty medication needs
• Liaise with physicians, advanced practice clinicians, pharmacists, nurses, and social workers
• Facilitate enrollment in patient assistance programs and gather documentation
• Organize daily outreach tasks for prescription refills, delivery coordination, and claim processing
• Coordinate patient outreach during clinic visits or via telephone follow-up
• Track clinic intervention outcomes and support quality improvement goals

• High school diploma or equivalent
• Registration with Kentucky Board of Pharmacy upon hire date
• Pharmacy technician experience required
• Prior experience with third-party billing, financial counseling, or medical terminology and coding preferred
• Prior experience with Epic electronic medical record preferred
• Subject to post-offer, pre-employment drug testing

Demonstrates expertise in benefit investigations, prior authorization processes, and patient outreach coordination. Proficient in managing insurance information and utilizing Electronic Health Records for effective communication and documentation.

• Pharmacy Technician Experience
• Prior Authorization Processes
• Third-Party Billing
• Epic Electronic Medical Record
• Patient Outreach Coordination

• Benefit Investigations
• Insurance Information Management
• Medication Concerns Triage
• Patient Assistance Programs
• Quality Improvement Support

• Effective Communication
• Collaboration with Healthcare Professionals
• Organizational Skills

• Registration with Kentucky Board of Pharmacy

• Payer Formularies
• Reimbursement
• Financial Counseling
• Medical Terminology
• Clinical Questions

• Electronic Health Record