Personal Care Specialist

- Maintain accurate patient records by documenting interactions, updating case notes in pharmacy systems, and ensuring compliance with applicable privacy and documentation requirements.

- Process prior authorization requests by gathering clinical documentation, completing payer-specific forms using established templates, submitting applications, and tracking their progress.

- Verify patient insurance coverage by reviewing insurance cards, checking formulary information, confirming coverage details, and accurately recording relevant findings.

- Support patient enrollment in financial assistance programs by collecting eligibility information, completing manufacturer copayment assistance applications, and submitting documentation to the appropriate program administrators.

- Coordinate specialty pharmacy referrals by processing referral forms, verifying insurance benefits, scheduling patient communications, and liaising with specialty pharmacy teams.

- Respond to routine patient inquiries by providing updates on application and authorization status, answering basic questions using approved scripts, and escalating complex issues to the appropriate team members.

- Monitor outstanding prior authorization requests, track submission dates, follow up with insurance payers, and communicate delays, denials, or other issues to senior staff.

- Ensure patient information is handled securely and confidentially, following applicable privacy legislation, internal policies, and healthcare compliance standards.

- Collaborate with internal colleagues and external healthcare partners to support efficient workflows, timely processing, and a positive patient experience.

- Maintain organized documentation and follow established procedures to ensure administrative accuracy and continuity of patient support.

- A high school diploma, GED, or equivalent practical experience is required.

- An associate degree in healthcare administration, life sciences, pharmacy technology, or a related discipline is preferred; equivalent relevant experience may also be considered.

- At least three years of experience in pharmacy support, prior authorization processing, insurance verification, healthcare administration, or a comparable healthcare-related role is required.

- HIPAA training or applicable healthcare privacy and compliance training is required, along with an understanding of confidentiality requirements when handling sensitive patient information.

- Strong organizational skills and attention to detail, with the ability to manage multiple requests, maintain accurate records, and meet processing deadlines.

- Familiarity with insurance verification, payer requirements, prior authorization workflows, pharmacy systems, and patient assistance programs.

- Effective written and verbal communication skills, with the ability to interact professionally with patients, insurance providers, pharmacy teams, and internal stakeholders.

- A patient-focused and empathetic approach, demonstrating professionalism, discretion, and sensitivity when responding to healthcare-related inquiries.

- Strong problem-solving and follow-up skills, including the ability to identify missing documentation, track pending requests, and escalation issues appropriately.

- The ability to follow standardized procedures and communication scripts while recognizing situations that require additional support or escalation.

- Proficiency with computer systems and administrative tools, including the ability to maintain electronic records and manage documentation accurately.

- The ability to work independently in a remote environment while collaborating effectively with a broader healthcare support team.

- Full-time remote work:
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