Patient Support Pharmacy Solutions Coordinator

🕒 May 12

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Phil, Inc.

WebsiteLinkedInAll Job Openings

51 - 200 employees

⚕️ Healthcare Insurance

☁️ SaaS

🧬 Biotechnology

Healthcare Insurance • SaaS • Biotechnology

Phil, Inc. is a company on a mission to simplify medication access for patients by helping them receive their medications quickly, easily, and affordably. The company offers the PhilRx Digital Hub Platform, which streamlines medication access for patients and providers, supporting retail and specialty-lite manufacturers. Phil, Inc. 's platform is designed to improve health outcomes by removing barriers and ensuring efficient medication dispensing, optimizing coverage and patient adherence, and supporting healthcare providers. Through strategic partnerships, Phil, Inc. helps maximize the value of access programs for life sciences brands, enhancing patient access and provider engagement.

📋 Description

• Conduct thorough research on order and ticket history to recommend the best resolution that aligns with department guidelines. • Ensure all Service Level Agreements (SLAs) are met. • Contact relevant stakeholders to resolve issues that require cross functional collaboration that may impact a successful patient experience. • Build strong internal and external rapport, maintaining positive customer and partner relationships. • Review and respond to internal escalation requests in a timely and accurate manner. • Proactively initiate, troubleshoot, and resolve PAs and appeals via vendor portals; analyze determination trends to provide valuable insights for patient education. • Serve as the expert liaison between prescribers, insurance payers, and partner pharmacies, translating technical hurdles into actionable solutions that ensure patient access to therapy. • Partner closely with Customer Support to provide clear, jargon-free updates and documentation in our operating systems, ensuring the team has the patient-ready insights needed to support the patient’s journey. • Efficiently navigate multiple software systems and vendor portals with a self-starter mindset, maintaining the flexibility to prioritize tasks based on clinical urgency. • Investigates complex claim rejections and partners with payers and pharmacies to diagnose root causes and establish and execute a clear resolution pathway that is in accordance with regulatory requirements and manufacturer business rules. • Act as the primary technical "fixer" for orders falling outside standard workflows, resolving obstacles such as insurance exceptions, pharmacy rejections, failed transfers, and state-specific shipping regulations.

🎯 Requirements

• Licensed Pharmacy Technician in your state of residence • Minimum 3 years of professional pharmacy technician or prior authorization experience • Proven abilities in complex problem-solving and critical thinking. • Highly resourceful, detail-oriented, and capable of seeing complex issues through to completion. • Demonstrated adaptability to swift program and process changes. • Familiarity with Zendesk, Phil Dashboard, Phil organization structure, and processes. • Good general understanding of computers, hardware, networks, and related technology. • Minimum 3 months of tenure with Phil (Internal Candidates). • Consistent history of great attendance. • Average performance scores of 95% QA.

🏖️ Benefits

• Overtime (OT) and holiday work may be required.