Pharmacy Support Liaison, Bolwell

Cleveland, OH, USA|

Job Overview

Compensation

Hourly

Range $22.22 - $34.76

Benefits

sign on bonus

Health Insurance

Dental Insurance

Paid Time Off

Retirement Plan

Professional Development

Employee assistance program

Job Description

University Hospitals (UH) is a leading healthcare organization known for its commitment to providing high-quality patient care through innovation, research, and community service. As a comprehensive medical enterprise, UH operates a network of hospitals, outpatient centers, and specialized care units. The organization values teamwork, excellence, and compassionate care, supporting both patients and staff with robust resources and state-of-the-art technology. UH emphasizes professional growth, education, and maintaining the highest standards in healthcare delivery. It is widely recognized for integrating clinical expertise with cutting-edge research to improve patient outcomes. \n\nThe role of Pharmacy Support Liaison at UH Meds enterprise represents a vital position within the pharmacy operations team. This role specifically targets ensuring optimal intake, billing, and reimbursement processes for high-cost and infusion medications for patients receiving care within the home care setting. The Pharmacy Support Liaison is responsible for a wide range of activities including verifying insurance coverage, managing prior authorization processes, adjudicating claims, and facilitating communication among clinical teams such as home care RN coordinators and pharmacists. This position demands a strong understanding of Medicare, Medicaid, and commercial insurance payment regulations specific to home care pharmacy services. \n\nIn this dynamic role, the Pharmacy Support Liaison acts as a key point of contact to handle insurance verification for new patient referrals and therapy modifications, while also ensuring all necessary clinical documentation is collected prior to patient acceptance. The position coordinates with various stakeholders to prevent therapy interruptions and optimize pharmacy revenue cycles. The duties extend to direct communication with patients to verify benefits and assist with patient assistance and copay programs, bolstering access to essential medications. The Pharmacy Support Liaison supports pharmacy workflow efficiency by working collaboratively with pharmacists, care coordinators, physicians, and nursing staff to address insurance issues and alternative care delivery options as needed. This position also contributes to staff training, competency development, and participates in revenue cycle committees to resolve denied claims and improve reimbursement procedures. \n\nThis is a full-time opportunity that offers a competitive experience within a highly supportive healthcare environment with the added benefit of a generous $3,000 sign-on bonus to attract the best candidates. The role involves direct patient engagement through telepharmacy support, managing inquiries, complaints, and providing assistance to healthcare providers and patients alike. Additionally, this position is responsible for maintaining patient confidentiality and adhering strictly to all policies related to Protected Health Information (PHI) security and compliance. Overall, joining UH in this Pharmacy Support Liaison capacity offers candidates a cohesive, meaningful career path with opportunities for professional growth, clinical collaboration, and impact in patient-centered care.

Job Requirements

High school equivalent or GED
Minimum 3 years clinical experience in medical or healthcare setting
Proficiency in medical terminology and coding systems
Knowledge of insurance billing practices and regulations
Experience with patient assistance programs
Certified Pharmacy Technician (CPhT) upon hire
Ability to comply with policies on Protected Health Information security
Willingness to participate in staff training and competency programs
Ability to perform occasional physical demands such as standing, walking, lifting up to 20 lbs
Must be able to travel up to 10 percent

Job Qualifications

High school equivalent or GED
Bachelor's degree in health care related or business field preferred
Minimum 3 years strong clinical background experience in a medical office or health care setting
Proficiency in medical terminology and ICD9, ICD10, CPT, DRG codes
Knowledge of third-party insurance billing practices and relevant federal and state regulations
Experience with patient assistance programs
Certified Pharmacy Technician (CPhT) required upon hire

Job Duties

Access care management documentation systems for data entry and support programs and processes by collecting member eligibility, benefits and contracts information
Perform intake of service requests from providers or members electronically, via telephone, or fax
Triage and respond to incoming phone calls providing information and assistance
Authorize services based on plan design or clinical guidelines in accordance with department policies
Improve patient service experience and maximize pharmacy revenue through prior authorization services
Conduct patient insurance, benefits and financial investigations by communicating with patients
Complete initial and renewal prior authorization forms and negotiate with insurers
Identify patient needs and ensure coverage of medication, obtaining information for patient assistance if needed
Facilitate enrollment in patient assistance programs and collaborate with social services and case management
Expedite pharmacy workflow and enhance patient care by preventing therapy interruptions
Participate in revenue cycle committees to resolve denied claims and improve revenue capture
Facilitate staff training, competency, education, and practice advancement
Answer incoming calls and respond to electronic communications for patient engagement telepharmacy support
Assist health care providers and patients by answering questions and referring inquiries to pharmacists
Handle customer inquiries and complaints via phone and email
Perform additional duties as assigned
Comply with all policies and standards
Maintain confidentiality and security of Protected Health Information (PHI)