Personal Care Coordinator - PersonalRX

Personal Care Coordinator (PCC)

The Personal Care Coordinator is responsible for the following processes:

Daily 

• Schedule mid-month patient calls (post first fill)
• Review patient profile prior to the mid-month call to see if the patient needs any new prescriptions (i.e., no refills remaining)
• Conduct mid-month patient calls and update the notes as needed
• Follow-up with patient to collect any monies owed
• Update fill lists 
• Call the patient’s doctor to get new prescriptions and/or renewals and contact the patient to let them know the new prescription/renewal was received. Note: If the PCC has trouble contacting the doctor, then the PCC will let the patient know and ask them to contact their doctor
• Get to know your patients and become an integral part of their care team
• pdate/enter patient contact(s) and their role and relationship, type of contact, contact method and notes 
• Obtain from the customer the drug name or Rx number of the prescription(s) that needs to be refilled
• Enter the appropriate information into  Rx² in order to generate labels for the new or re-filled prescriptions
• Answer the telephone and direct calls to the pharmacist (where appropriate) such as, but may not be limited to, the following:
  • New prescriptions
  • Medical questions
  • Judgmental decisions

• Enter the appropriate information into  Rx² in order to process electronic third party claims for payment by insurance companies for prescriptions. If the insurance company does not get billed electronically, then the registered pharmacy technician shall gather the necessary billing forms for paper claims to insurance companies for payment of prescriptions.

• Process future dated claims
• Resolve rejected claims
   

Ad-Hoc

• Answer patient questions on their medications, refer all to a Pharmacist if needed, update patient notes as needed
• Manage patient supplied medications (keep extra medications and contact the patient if more medications are required for subsequent fills)
• Work with Finance and Senior Management  if patient balance > $50 or more than two months old
• Take patients off-service only after getting approval from senior management, enter close reason for each patient and update notes
• Maintain the current patient address (i.e., for snowbirds)
• Complete assigned monthly review of medications to determine if any in stock medications are nearing an expiration date (SOP 4.4 - Removing Expired Medications From Inventory)
• Set and complete tasks related to follow-ups in Rx2 to ensure the above work is completed in a timely manner
• Review existing SOPs and Policy and Procedures and enhance/update as needed
• Identify issues/topics  that require a new policy or procedure - and share with management

Overall

• Communicate with team members about any issues that require input from others (e.g., pharmacists, pharmacy technicians, billing and insurance specialists)
• Learn company policies and procedures, and adhere to them
• Follow all laws and regulations concerning patient privacy and every aspect of HIPAA (Health Insurance Portability and Accountability Act)
• Identify issues that require a new Standard Operating Procedure (SOP) or Policy and Procedure and share with management
• Answer the phone in a timely manner
• Enthusiastically participate in company meetings 

Qualifications

Licensure

Computer Skills

Language SKills
Ongoing Education Reqs

• Individual must not be on the government exclusion lists as determined by the Office of the Inspector General (OIG) and System for Award Management (SAM)
• Education - College (preferred)
• Pharmacy technician license (required)
• Computer proficiency
   

Exempt/
Non-Exempt
 

Exempt (not available for overtime)

Key Metrics

• # patients managed
• % patient retention
• patient satisfaction
• # referrals