Pharmacy Care Coordinator - Specialty Pharmacy Berwyn, PA

Pharmacy Technician - Specialty Pharmacy

Shape the Future of Healthcare

We're seeking a Pharmacy Technician, or Care Coordinator, to join our dynamic team at Ascella Health, where your expertise will directly contribute to improving health outcomes for patients with complex, chronic conditions and rare diseases. This role offers the opportunity to serve as a patient’s first or ongoing point of contact. They will act as the patient advocate and champion, guiding patients through obtaining pharmaceuticals unavailable at chain pharmacies.

This role will be based at our Ascella Health office in Berwyn, PA, and will require being in the office 5 days a week, Monday through Friday, for the first 90 days for training purposes. After that, it will be a hybrid role that requires in-office work three (3) days per week.

Apply now and join Ascella Health - Where Innovation Meets Patient Care!

• Act as a patient advocate to gain insurance coverage for prescribed therapies.
• Welcome new patients and create profiles with all the critical information.
• Conduct periodic insurance verification and/or authorizations for patient coverage.
• File claims for patient prescriptions and orders.
• Complete collection activities per client program specifications.
• Provide an initial and ongoing investigation and benefit explanation to the patient.
• Obtain and maintain Prior Authorizations.
• Create patient orders and associated prescription entries for new and refilled prescriptions.
• Communicate with prescribers, including requesting new prescriptions.
• Bill appropriate entities for RX drugs and administration supplies.
• Assist patients with possible financial assistance.
• Arrange all necessary documents and materials for initial and ongoing shipments.
• Coordinate all deliveries and process any patient returns.
• Obtain necessary consent forms for manufacturers or patient support organizations.
• Assist pharmacists with day-to-day tasks such as filling prescriptions and entering prescription information into the patient management system for pharmacist verification.
• Assist in preparing any ad hoc report requests from clients.
• Perform other related duties as assigned or as necessary; remains flexible and adaptable in work schedules and work assignments as defined by departmental and organization needs.

Patient advocacy and support – You will guide patients through the process of obtaining specialized medications.

Insurance and coordination – You will conduct and complete insurance verifications, prior authorizations, and filing of claims – means of helping patients gain insurance coverage.

Ensuring patient satisfaction – You will deliver exceptional white-glove service by welcoming new patients and guiding them seamlessly through the specialized medication acquisition process, including securing possible financial assistance options and coordinating timely deliveries to ensure optimal patient satisfaction and care outcomes.

• Knowledge of medical terminology required
• Knowledge of medical/pharmacy insurance benefit language- ie. EOBs, deductibles, out-of-pocket, co-insurance, co-pays, etc.
• Ability to define CMS 1500s, provider numbers, CPT, HCPC’s, 1CD9, NCPDP, and NDC codes/numbers
• Knowledge of Medicare and Medicaid billing
• Experience with prior authorization and SMN preparation
• Knowledge of insurance claim appeals
• Strong attention to detail and the ability to be a creative self-starter and team player
• Computer literate and proficient with Microsoft Office
• Ability to participate in and facilitate group meetings
• Must be able to effectively multitask and work in a fast-paced environment, with the ability to prioritize competing tasks
• Excellent analytical skills and the ability to provide solutions to complex problems
• Ability to be highly transparent, ethical, and driven
• Excellent written and verbal communication skills and interpersonal skills are required
• Willingness to work a flexible schedule

• A high school diploma or equivalent is required.
• 2 or more years of experience with medical/pharmacy insurance verification, including benefit…