Specialty Pharmacy Representative I

Job description

Job Details PRIMARY RESPONSIBILITIES: The Specialty Pharmacy Representative I drives our refill queues and assists patients, physicians and pharmacists in the completion of: claim adjudication/review, benefit investigations, financial assistance applications, refill/adherence activities, and other programs that drive optimal outcomes for Jefferson Specialty Pharmacy patients. Responsibilities include entering the patient information; name, date of birth, insurance information, allergies and medication history into our therapy-specific patient assessment software. Assist with the filling and distribution of prescriptions, under the direction of a patient care pharmacist, in accordance with the law. Job Description: ESSENTIAL FUNCTIONS: - Adjudicate and review claims responses for reimbursement and profitability - Analyze claims messages to determine next steps for order escalation as needed: Prior Authorization, Benefits Investigation, Step Therapy, Non-Formulary, Financial Assistance, etc - Schedule delivery of high dollar/specialty medications as well as other maintenance medications to maintain patient adherence and compliance to prescribed therapy according to departmental polic...