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Moses Cone Health System

SpecialtyPharmacy Patient Advocate

Moses Cone Health System - Greensboro, NC

Job Description
LOCATION:  Greensboro, Moses Cone HospitalWORK TYPE: Full Time (40 hours/week)Exempt: NoSCHEDULE: FTE: 1.0 (40 hours/week)Shift: DaySchedule: M-F; 8-4:30; possiblity of nights/wkds in futureOn Call: NoJOB SUMMARY:Under general supervision verifies insurance eligibility, benefits, verification, prior authorization and researches denied services to ensure payments are processed on a timely basis. Acts as a liaison to ensure accurate processing of all claims.  Enrolls patients in pharmacy services and ensures patients have timely access to medication and medication refills.MAJOR WORK ACTIVITIES:1.Patient Advocacy 20 %Works as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays2.Benefits Investigation 20 %Performs benefits investigations on all patients receiving specialty medications. Obtains insurance prior authorizations insured patients and coordinates with manufacturer assistance programs for uninsured or underinsured patients.3.Copay Assistance \tAssists patients with copay assistance via manufacturer programs and grant foundations.\t10%4.Collaborative Practice 10%\tWorks collaboratively with clinical pharmacist practitioner (CPP)/Ambulatory Care Pharmacists (ACP) and care team to obtain clinical and financial information needed for program enrollment and prior authorization for insured and uninsured patients. 5.Documentation\t 10%Utilize internally developed systems, commercial vendor software (to track patient eligibility, prescriptions, patient communications and program enrollment) and inpatient and outpatient clinical, scheduling and financial systems as necessary (e.g. Cone Health Link (CHL)).6.Patient Liaison 10%\tActs as a liaison between the patient, clinic, and pharmacy. \t7.Refill and Adherence Tracking\t10%Work collaboratively with care team to coordinate refill phone calls to patients, and follow up on medication delivery\t8.Customer Service 10%\tInteract with physicians, nurses, and other health care providers in a courteous and professional manner and display the highest level of customer service, attentiveness, and consideration possible in all situations\tEDUCATION:Required:High school diploma or certificate of equivalency to include basic arithmetic, algebra, reading, and writing as well as some basic chemistry skills (ability to identify medications requiring specialized handling).EXPERIENCE:Required:Three years of pharmacy technician work experience or three years prior authorization and/or copay assistance programs work experience or three years combined pharmacy technician/prior authorization and copay assistance work experienceKNOWLEDGE, SKILLS, AND ABILITIES:Required:• Demonstrates independence, time management, efficiency, and accountability for actions.• Ability to demonstrate visual, written, and verbal communication skills.• Computer skills (word processing or data entry).• Ability to perform repetitive motions including bending, twisting, stooping, pushing and pulling. Must be able to lift 10 pounds and may require lifting up to 40 pounds to counter height of 3-4 feet five times daily. Ability to push rolling carts weighing 300 pounds with handles at 3.5-4 foot level daily. Ability to stand for long periods of time and the ability to climb one to two flights of stairs as needed. Specific vision abilities including color vision, close vision, depth perception, and ability to focus. Physical job demands may be subject to possible modifications to reasonably accommodate individuals with disabilities.• Ability to perform simple math skills.CONDITIONS OF EMPLOYMENT:* Annual flu shot* Annual TB test (if applicable to your job location)* Annual CBLs (Safety at Work and Corporate Compliance)* Maintain licensure/certification/registry/listing (if applicable to your job)ABOUT CONE HEALTH:Cone Health is a state of the art network of facilities providing patients access to the latest developments in medical care from their first moments of life through later years. Our network offers the most breakthrough treatments and technology available in healthcare today. As a teaching hospital, we offer employees the opportunity to become leaders in the industry and continued growth from their first day on.  Extraordinary patient care is about being “high-touch” as well as “high-tech”. Community service and superior patient care are the cornerstones of our organization, a philosophy that is demonstrated by each and every one of our valued team members. We are proud to be the largest private, not-for-profit employer of choice in the Piedmont, NC area community.  Additionally, as one of the region’s largest and most comprehensive health networks, Cone Health has more than 100 locations, including six hospitals, three ambulatory care centers, three outpatient surgery centers, four urgent care centers, a retirement community, and more than 100 physician practice sites. Our tagline – “The Network for Exceptional Care” – highlights our commitment to excellence, which is shared by our more than 11,000 employees, 1,300 physicians and 1,200 volunteers.Cone Health is an equal opportunity employer. If you require assistance with our online job submission process, please contact our Talent Acquisition team at 866-266-3767 to request an accommodation.

5 days 5 hours ago

Moses Cone Health System


SpecialtyPharmacy Patient Advocate Moses Cone Health System - Greensboro, NC, United States


Location: Greensboro, NC

Company Profile:
Moses Cone Health System is a multi-hospital system with a range of outpatient services designed to provide care for Piedmont residents throughout all stages of their lives. Residents of our primary service area of Guilford, Randolph, Rockingham and Alamance counties and the city of Kernersville depend on us for convenient, affordable and compassionate care - care delivered regardless of a patient s ability to pay.