Patient Services Specialist

PRIMARY DUTIES AND RESPONSIBILITIES

• Perform patient onboarding, benefit verification, prior authorization, financial assistance, and appeals processes on behalf of patients and physicians to facilitate the process between the doctor’s office and pharmacy.
• Provide services for ambulatory pharmacy, specialty pharmacy, and outpatient infusion center environments as requested.
• Interact with patients and providers to obtain insurance benefits and patient information needed for prior authorizations, ensuring medication reimbursement.
• Ensure patient‑specific reimbursement‑related information is obtained and available for tracking replacement products, including maintaining files and documentation for PAP applications.
• Obtain signatures and documentation for completed PAP applications prior to submission.
• Complete patient adherence activities such as notification of upcoming refills, coordination, tracking, and confirmation of prescription delivery.
• Work within the health system’s EMR systems (e.g., Indi Care™) to support workflow management and document activities.
• Provide integrated services to increase prescription capture rate, ensure timely infusion medication delivery, improve patient outcomes, and reduce readmissions.
• Resolve reimbursement barriers proactively at assigned facilities and update the Patient Access Management team.
• Build business relationships with clinic staff, pharmacy, and hospital contacts, informing them of changes in site‑specific recovery potential based on PAPs.
• Assist on special projects within job scope to improve reimbursement optimization.
• Communicate patient and provider feedback to PHS management for process improvement.
• Interface appropriately with key account associates regarding additional products and services.
• Demonstrate flexibility and adapt to changes in payer, pharmacy, and patient assistance program processes.
• Provide temporary coverage for clients and patients during onsite resource absences.

• Broad training in fields such as Medical Office Administration, Social Work, Medical Records/Billing, Benefit Verification, Patient Financial Services, Pharmacy, Nursing, or similar vocations, generally obtained through a 2‑year Associate Degree, technical vocational training, or an equivalent combination of experience and education.
• Bachelor’s degree program preferred.
• 2+ years of directly related or relevant experience.
• Pharmacy Technician Certification Board (PTCB) certification required.
• CPhT certification required.

• Effective communication skills, both oral and written.
• Strong organizational skills and attention to detail.
• Ability to work quickly and accurately under time and volume constraints.
• Proactive and tenacious in seeking solutions with minimal supervision.
• Competence in Microsoft Excel and Word.
• Strong analytical skills.
• Strong interpersonal skills.
• Familiarity with insurance/claims processing, pharmaceutical products, services, software, and drug interactions.

The work environment is generally quiet with reasonable noise levels. The role may involve sedentary activity such as reaching, lifting, finger dexterity, repetitive motions, talking, and hearing. Approximately 75% or more of the time is spent looking directly at a computer.

Requirements include sedentary physical activity, reaching, lifting, finger dexterity, grasping, repetitive motions, talking, hearing, and close visual focus. The associate may be required to stand, walk, or otherwise be mobile, and must be able to deal with stressful situations as they arise.

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day. In addition to traditional offerings such as medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This includes support for working families, backup dependent care, adoption assistance, infertility coverage, family building support, behavioral…