Patient Care Coordinator, Specialty Pharmacy
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Job Description
Remote Patient Care Coordinator supporting Evernorth specialty pharmacy patients. Managing prior authorizations, claims, medication deliveries, and patient case coordination.
Responsibilities:
- Serve as the primary coordinator for patient cases from referral through therapy completion
- Complete prior authorization documentation, schedule medication deliveries, and facilitate document retrieval within required timelines
- Provide customer service and empathetic support in a phone-based environment
- Perform claim adjudication, prior authorizations, billing, and eligibility checks, including outbound calls
- Collaborate with pharmacists, technicians, and healthcare professionals to resolve patient issues and maintain continuity of care
- Conduct welcome calls and outreach for new patient onboarding
- Maintain patient records through benefit verification, therapy initiation, follow-up, and case closure
- Use software platforms to manage authorizations, medication profiles, and patient communication
- Assist with patient questions and provide backup during high-volume periods
- Identify and document case concerns, escalations, and process gaps for leadership review
- Uphold patient confidentiality and follow internal policies and accreditation standards
- Complete additional duties as assigned
Requirements:
- High school diploma or equivalent
- Registered Pharmacy Technician licensure
- Minimum of 2 years of healthcare or specialty pharmacy experience
- Strong computer proficiency, including Windows, Excel, and Word
- Comfort working in a phone-based environment
- Strong verbal and written communication skills
- Ability to work independently and collaboratively in a fast-paced environment
- Strong organizational skills
- Pacific Standard Time hours
- Reliable cable broadband or fiber optic internet connection if working from home, with at least 10 Mbps download and 5 Mbps upload
- Preferred qualifications include National Certified Pharmacy Technician (PTCB), but this is not required
- Preferred licensure in Alabama, Florida, Tennessee, Montana, Ohio, Texas, or New York, but this is not required
- Willingness to obtain registration in additional states
- Knowledge of pharmacy terminology, insurance processes, medical terminology, and basic pharmaceutical law is preferred
Benefits:
- Annual bonus plan eligibility
- Medical benefits
- Vision benefits
- Dental benefits
- Well-being and behavioral health programs
- 401(k)
- Company-paid life insurance
- Tuition reimbursement
- Minimum of 18 days of paid time off per year
- Paid holidays
- Leaves of absence
- Tobacco-free policy
- Reasonable accommodation support
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