Specialty Pharmacy Liaison

Job Summary: Responsible for all aspects of drafting and completing prior authorizations, entering of medication orders and customer service for patients, and working as liaison with pharmacy team and provider offices. Educate prospective pharmacy patients on how the specialty pharmacy serves patients and improves their overall care Resolve insurance related issues, complete benefit investigations, including prior authorizations (PAs) as an agent of the providerReview the patients need for financial assistance and secure financial assistance when needed and availableDocument patient information within the hospital EMR, QS1, Therigy and all proprietary tools as requiredSecure prescription renewalsCommunicate directly with patients to assist them in the awareness of their medicationsIdentify medications requiring special storage and/or handling such as hazardous medications and/or refrigerated medicationAnswer, resolve and triage inbound inquiriesApply observations and recommendations to operational issues, increased productivity, quality, and customer-service standardsActively participate in process improvement initiatives.Responsible for monitoring adjudication queue(s) and facilitate prior authorization process for customersResponsible for ensuring a high level of successful prior authorizations Responsible for Appeals Requests and External Appeals Requests when necessary.Act as liaison with Clinical and Pharmacy Team in communicating with provider offices on questions regarding appropriateness of therapy, labs or other questions/concerns and provide support for prior authorization, financial assistance, and prescription fill and renewalResponsible for accurate selecting billing and shipping methods for incoming patient ordersDocument patient reported information into TherigySTMResponsible for accurate data entry of incoming prescriptions, if requiredProvides resolution to customer service issues to ensure member satisfactionCustomer service coverage for incoming calls, and making outbound calls to set up customer deliveriesResponsible for completing all mandatory and regulatory training programsPerform other duties as assignedEducational Requirements:Minimum: High School Diploma or GEDPreferred: Pharmacy technician or related certificationExperience: Experience with Prescription Prior Authorizations required6-12 months experience as a pharmacy technician preferredJob Skill Requirements: Broad knowledge of medications, physician orders, and pharmacy systemsFamiliar with Enterprise billing options and practices surrounding claim submissionStrong communication skills Outstanding customer service skillsExcellent organization skillsAbility to multitask and prioritize Excellent computer and keyboarding skillsCompensation:$18.02-27.03 per hour.The final offer will be determined after careful consideration of multiple factors such as relevant skills, years of experience and education.KPH Healthcare Services, Inc. is a multistate organization and abides by all local, state and federal regulations as it pertains to minimum wage requirements.

Created: 2025-11-21