Job Purpose:   Primarily supports the patient outreach team by assisting to onboard/enroll patients onto the Shields hospital partner pharmacy program.   This role will spend most of the remaining time assisting the benefit verification team by running test claims to determine copay amounts and patient eligibility checks.  This role will be a great opportunity for someone to learn some of the patient facing skills for future career growth opportunities. Job Duties: <ul> <li>Enroll eligible patients into the Shields partner health system pharmacy program.</li> <li>Call and/or communicate directly with patients when completing the enrollment process.</li> <li>Work with regional leaders and Liaisons to ensure patients are properly and fully onboarded.</li> <li>Ensure patients are properly setup in the pharmacy to receive their medication from the new pharmacy without interruption or gap in care.</li> <li>Performs test claims to verify pharmacy copay amount.</li> <li>Verifies insurance eligibility and benefit levels.</li> <li>Utilize multiple approved tools to identify insurance coverage.</li> <li>Research within patients medical records for current medication regimen.</li> <li>Complete benefits investigation with approved Pharmacy Dispensing Systems.</li> <li>Document clearly and concisely all outcomes of benefits investigation in documentation tool.</li> <li>Collaborate with team members to provide an integrated approach of quality patient care.</li> <li>Apply observations and recommendations to operational issues, increased productivity, quality, and customer-service standards.</li> <li>Identify trends, resolve problems; recommend improvements; implement change.</li> <li>Actively participate in process improvement initiatives.</li> <li>Act as a value-added business partner to stakeholders throughout the organization.</li> <li>Protect organizations values by keeping information confidential.</li> <li>Update job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.</li> <li>Shift Hours: Flexible scheduling to meet needs of health system partners.  Generally Monday-Friday during hours of operation of the Patient Outreach team (hours will depend on what time zone the candidate works and what time zone the patient lives in to support patient follow up calls).</li> <li>Other duties as assigned.</li> </ul>   Skills: <ul> <li>We are looking for individuals who enjoy talking to patients or are excited about the opportunity to talk directly with patients and/or clinical support teams.</li> <li>We are looking for someone with strong computer skills and the ability to quickly learn to navigate Electronic Medical Records (EMR) and Pharmacy Dispensing Systems (PDS).</li> <li>The applicant should be very organized self-motivated with attention to detail and have great interpersonal skills, high integrity and be dependable.</li> <li>The ideal candidate will be an energetic and highly motivated, team player with a willingness to do whatever is necessary for the betterment of the company. Discretion and confidentiality are essential as position deals with highly sensitive and private data.</li> </ul>   Experience/ Education: Required Licensure/Certification:  We are seeking experienced pharmacy technicians. Nationally certified from PTCB or equivalent is strongly preferred but not required. Should licensure need to be obtained, the applicant will commit to obtaining the required licensure within a mutually agreed upon timeframe. Continued employment is contingent upon meeting these requirements. Years of Experience: Required 1+ years as a Pharmacy Technician Education: High school diploma or GED required<div>California residents employed by or applying for work at Shields have certain privacy rights. Please review our: <a href="https://www.shieldshealthsolutions.com/wp-content/uploads/2023/01/CPRA-Notice-Shields-Website-January-1-2023.pdf" target="_blank">California Workforce Privacy Notice</a> and <a href="https://www.shieldshealthsolutions.com/privacy-policy/" target="_blank">Privacy Policy.  </a> Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.</div>