Pharmacy Services Representative (PSR) works under the direction of Clinical Pharmacists to provide pharmacy services with compassion, excellence and efficiency. The PSR is responsible for managing orders received at the CHRISTUS Specialty Pharmacy and serving as a liaison between patient, plan, provider and pharmacy.
Performs data entry and patient benefit eligibility verification
Completes prior authorization requests, submits to insurance, and verifies completion
Acts as a liaison between patients and insurance companies, and facilitates communication between patients and doctors, medical staff and administrative staff.
Answers patient inquiries about billing, procedures, policies and available services
Responsible for incoming and outgoing calls from customers regarding drug delivery, set-up, and all related services
Coordinates financial arrangements and collects co-payments
Must function in strict accordance with written policies and procedures
Ensures safe, appropriate, cost effective drug therapies for patients according to established policies, procedures, and protocols.
Reads, extracts and interprets information in patient medical records accurately.
Detects and reports suspected adverse drug reactions accurately and in a timely manner.
Coordinates pharmacist drug education to patients and their families per institutional protocol.
Participates in the quality improvement activities of the department.
Contributes to the quality and effective operation of the department.
Is punctual and dependable; reports to work as scheduled. Absenteeism and tardiness are within policy guidelines.
Maintains a neat, professional, well-groomed appearance. Wears identification badge.
Performs work within specified timeframes. Adapts positively to frequent interruptions and changes in workload and/or work schedule.
Provides courteous, cooperative and timely service to patients, visitors and staff.
Demonstrates good verbal and written communication.
Works cooperatively with hospital and pharmacy staff. Voices concerns and suggestions to appropriate persons in a positive manner. Fosters a team environment.
Demonstrates sound professional judgment consistent with clinical/academic background.
Maintains strict confidentiality of patients, guests and employee information.
Complies with all requirements related to risk management, safety, security, fire and infection control.
Adheres to hospital and departmental policies and procedures. Complies with all applicable Federal and State laws, rules and regulations.
Works independently with minimal supervision. Organizes and prioritizes work assignments.
Ensures pharmacy services are provided in a timely manner.
Answers the telephone, identifying self and department. Directs calls to appropriate personnel.
Required: 18 years old; High School diploma, or equivalent.
Minimum 2 years' experience working at a community pharmacy or health plan
Experience in third party billing and benefits investigation required
Specialty pharmacy experience preferred
Knowledge of QS1 billing software, EPIC EMR and CoverMyMeds preferred
Registered pharmacy technician in the state of practice required.
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.