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Skills: Pharmacy benefit verification, Prior authorization, Claim adjudication, Electronic health records, Medical terminology
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King of Prussia, Pennsylvania, United States · On-site
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King of Prussia, Pennsylvania, United States · On-site
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King of Prussia, Pennsylvania, United States • On-site
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The Pharmacy Care Coordinator manages patient access to medication by handling benefit verification, prior authorizations, and insurance appeals. They also serve as a point of contact for patients and providers to resolve coverage barriers and document all activities in the electronic health record.
Candidates must have at least two years of relevant experience and a high school diploma or GED. Proficiency in insurance coverage processes, electronic health records, and strong communication skills are required.
SHIFT:
Day (United States of America)Seeking Breakthrough Makers
Children’s Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation.
At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care—and your career.
CHOP does not discriminate on the basis of race, color, sex, national origin, religion, or any other legally protected categories in any employment, training, or vendor decisions or programs. CHOP recognizes the critical importance of a workforce rich in varied backgrounds and experiences and engages in ongoing efforts to achieve that through equally varied and non-discriminatory means.
A Brief Overview
The Pharmacy Care Coordinator (PCC) ensures timely patient access to medication therapies by managing benefit verification, prior authorizations, reauthorizations, and appeals. This role will handle inbound calls (may include serving as a call center resource), triaging issues, providing explanations of benefits structures and copay assistance programs, and resolving complex coverage barriers. The PCC partners closely with patients, providers/clinic staff, payors, and internal and/or external pharmacies, while accurately documenting all activity in the electronic health record (EHR) through final authorization determination.
What you will do
To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must receive an annual influenza vaccine. Learn more.
EEO / VEVRAA Federal Contractor | Tobacco Statement
Salary ranges are shown for full-time jobs. If you're working part-time, your pay will be adjusted accordingly.
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At CHOP, we are committed to fair and transparent pay practices. Factors such as skills and experience could result in an offer above the salary range noted in this job posting. Click here for more information regarding CHOP's Compensation and Benefits.
Since its start in 1855 as the nation's first hospital devoted exclusively to caring for children, The Children's Hospital of Philadelphia has been the birthplace for many dramatic firsts in pediatric medicine. The Hospital has fostered medical discoveries and innovations that have improved pediatric healthcare and saved countless children’s lives. Today, The Children's Hospital of Philadelphia is one of the leading pediatric hospitals and research facilities in the world. Our 150 years of innovation and service to our patients, their families and our community reflect an ongoing commitment to exceptional patient care, training new generations of pediatric healthcare providers and pioneering significant research initiatives.
Offices: 34th St. and Civic Center Blvd., Philadelphia, PA 19104, US · 3401 Civic Center Blvd, Philadelphia, PA 19104, US
