BioMatrix is a nationwide, independently-owned infusion pharmacy with decades of experience supporting patients on specialty medication. Our compassionate care team helps patients navigate the often-challenging healthcare environment. We treat our patients like family and get them started on therapy quickly. We work closely with them as well as their family and their healthcare providers throughout the patient journey, staying focused on optimal clinical outcomes.
At BioMatrix the heart of our Inclusion, Diversity, Equity, & Access (IDEA) philosophy is the commitment to cultivate a welcoming space where everyone’s contributions are acknowledged and celebrated. Our goal is to draw in, develop, engage, and retain talented, high-performing individuals from diverse backgrounds and viewpoints. We believe that both respecting and embracing diversity enriches the experiences and successes of our patients, employees, and partners.
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As a key member of the Intake team, a Patient Access Liaison (PAL)- Active will be responsible for on-going monthly eligibility monitoring of Active patients. If/when change of insurance or benefits is identified, PAL- Active will work with patient, sales, and/or physician to obtain new insurance and/or supporting clinical documentation to secure authorization. PAL- Active will advise the Reimbursement Specialists of new insurance and the need for new benefits verification and prior authorization if applicable. PAL- Active will continue to be the point of contact with patients, sales, physician to provide updates as necessary and may also assist with authorization and benefits questions from patients as they arise.
A PAL- Active will be aligned to specific teams and will be responsible for monitoring coverage for that set of patients. This role will work closely with data entry, reimbursement, nurse coordination, and pharmacy operations team members supporting various stages of the intake and pharmacy management processes and will understand the case status and next steps for each referral they are responsible for supporting.
Location: Position on site Overland Park, KS or Garnet Valley, PA, or REMOTE
Schedule: 8:30 am-5:00 pm CST or EST
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QUALIFICATION REQUIREMENTS
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- 1-3 years of experience managing patient referral and prescription activities or reimbursement services in infusion or specialty therapies
- 1-3 years of experience providing customer service in health care setting (patients and/or providers), including meeting high quality standards for services and evaluation of customer satisfaction
- Electronic health medical record or pharmacy patient management experience
- High School Diploma or equivalent, Bachelors' Degree preferred
- Ability to multitask in a fast-paced environment
- Proficient in medical or pharmacy terminology, written or verbal
- Moderate skills in Microsoft Office (including Word, Excel, PowerPoint, etc.)
- Willing to travel up to 5% of the time for business purposes (when necessary to attend meetings, conferences, seminars, etc.)
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QUALIFICATIONS PREFERRED
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- 1-3 years of experience in supporting prescriber, healthcare setting, patient, and field facing communications related to referral or prescription services in infusion or specialty therapies
- General understanding of prescription benefits, insurance/payer requirements, and verification processes
- General experience working in a health care setting or services environment
- General knowledge of infusion therapy process and patient needs
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ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
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- Monitor CareTend queues for Active patients and review eligibility monthly. Ensure authorization is on file and there are no barriers to servicing a patient before Pharmacy team contacts patient to set up delivery.
- If any insurance coverage issues are identified, PAL- Active will work with patient, sales representative and Physician to obtain any necessary information for further review to overcome the barrier.
- Assist with PAL-Pending duties as needed for coverage or additional support
- Ensure last events are accurate and cases are progressing as expected
- Perform activities timely and ensure downstream teams are aware of any potential service delays
- Work closely with Reimbursement Specialists and conveys outcomes of benefit investigation activities with patient when it comes to patient out of pocket costs, financial responsibility, and financial assistance options for patient support consideration
- Work closely and communicate with Nurse Coordination team for those patients who intend to move forward with service and require in-home nurse care to be scheduled and organized around prescription fulfillment and shipping
- Work closely and communicate with Pharmacy operations team members ensuring clinical and fulfillment resources have everything they need to successfully support the on-boarding and on-going fulfillment for a new patient referral/prescription
- Produce written documentation representing all provider, patient, caregiver, and/or field team updates and communications in necessary systems of record
- Understand referral process, volume, and workload metrics and goals established by leadership; use goals to effectively organize referral workload and daily activities for successful outreach and completion of referral steps needed to attain service outcomes/determination
- Support use of technology and other innovative digital channels for internal and external stakeholder communication as directed by leadership; leverage professional and effective communication skills when utilizing technology for written correspondence with these stakeholders
- Have strong understanding of referral and prescription management processes and available services to effectively convey status, outcomes, and next steps to team members as well as referral source, patients, and field resources as expected and needed
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NON-ESSENTIAL FUNCTIONS & RESPONSIBILITIES
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- Ability to prioritize and handle multiple tasks and projects concurrently
- General knowledge and understanding of referral profitability and reimbursement options related to referral and patient population being served
- Support general administrative activities to navigate patient, provider, and field outreach (i.e. mailings, documentation development, scheduling of meetings/discussions, etc.)
- Must have scheduling flexibility and be able to work overtime (from time to time upon request)
- Careful attention to detail
- Act as a resource to other departments and participate in department meeting and office presentations with your expertise in this area of referral services
- Performs related duties as requested by leadership
- Participates in quality assurance activities and audits as directed
- Overnight travel on occasion by car and airplane
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KNOWLEDEGE, SKILLS AND ABILITIES REQUIREMENTS
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- Excellent customer service and communication skills (both written and verbal)
- Working knowledge of medical terminology
- Ability to perform referral related work and tasks in an organized fashion with focus on complete information and time related deadlines
- Ability to complete multiple projects with time sensitive deadlines
- Ability to manage more than one priority project at a time
- Ability to work as part of a team/committee to complete assigned tasks
- Ability to exercise independent judgment and at times, work independently
- Ability to enlist cooperation of other people and department in completing assigned work and projects
- Ability to actively communicate, inspire and motivate peers, customers, and other stakeholders encountered in the referral services department
- Ability to think and act strategically and proactively
- Ability to maintain accurate records and prepare reports and correspondence related to the work
Communication Skills
- Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; demonstrates group presentation skills; actively participates in meetings
- Written Communication - Writes clearly and informatively with professional context and direction; edits work for spelling and grammar; varies writing style to meet needs of audience; presents qualitative and quantitative data effectively; able to read and interpret written information effectively.
Computer Skills
- Become and remain proficient is all technology platforms, applications, and programs necessary to perform Patient Access Liaison (PAL)- Active duties
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BioMatrix Pay Range/Rate
$23 - $29 USD
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. If needing a reasonable accommodation within the application process, please contact the BioMatrix People & Culture team at Careers@BioMatrixsprx.com or 954.385.7322 x 1425.
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
OTHER
- Will participate in legal and ethical compliance training each year.
- Will consistently behave in compliance with the BioMatrix, LLC’s legal and ethical policies and procedures.
- Will abide by the policies of BioMatrix, LLC as set forth in the Compliance Manual.
- Will not participate in any conduct considered to be unethical or illegal.
EXPECTATION FOR ALL EMPLOYEES
Supports the organization's mission, vision, and values by exhibiting the following behaviors: integrity, dedication, compassion, enrichment and enthusiasm, places patients first, is all-in with stacked-hands, and is focused on relentless consistency wins.
GENERAL INFORMATION:
The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required of personnel so classified.
The incumbent must be able to work in a fast-paced environment with demonstrated ability to juggle and prioritize multiple, competing tasks and demands and to seek supervisory assistance as appropriate.
Incumbents within this position may be required to assist or find appropriate assistance to make accommodations for disabled individuals in order to ensure access to the organization's services (may include: visitors, patients, employees, or others).
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
