Providence Health & Services Home Service and Credena Health Access Services Representative in Portland, Oregon
Providence is calling a Home Service and Credena Health Access Services Representative - Home Services Specialty Pharmacy (1.0 FTE, Rotating/Variable) to Home Services Building in Portland, OR.
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We are seeking a Home Service and CredenaHealth Access Services Representative - Home Services Specialty Pharmacy that will be responsible for processing all new referrals for Home Services Pharmacy (HS) and CredenaHealth (CH) lines of business. These lines of business include Infusion Pharmacy (HS); Long Term Care pharmacy (HS) and Credena Health (CH). This work includes obtaining the order and other required documentation, conferencing with the referral source, the Pharmacist (HS and or CH) and HS Infusion Nurse Coordinator; and verifying insurance eligibility and benefits; cost of medication, obtaining pre-authorizations and re-authorizations and assisting patients with copay and financial assistance. This position is also responsible for monthly re-verification of insurance eligibility of active patients on service. The admission team member works closely with the Pharmacist (HS and or CH) and Nursing staff (HS) regarding all therapy changes and additions keeping patients' profile updated and retrieving new authorizations. The admission team member completes financial cost disclosure and other required documents for each ordered therapy and discuss patient's financial obligation before start of care.
In this position you will have the following responsibilities:
Receive, triage and document pharmacy incoming referrals, calls, faxes and requests related to the HS and CH pharmacy
Perform intake and system data entry of authorization and referral requests, patient information, discharge information, medication therapy management information and drug utilization management information
Identify the need for clinical review or pharmacist/physician intervention through sound judgment
Coordinate conference calls on new referrals with the intake pharmacist, referral source and intake team
Identify and obtain resources for referrals requiring immediate attention
Act as department liaison and resource to patients, health plan providers, physicians and pharmacy staff to problem solve through judgment address inquiries regarding work, workflow, processes and information system issues
Complete required paperwork for admit packet to include Advance Beneficiary Notice, patients financial obligation and copay/financial assistance
Address customer and referral source concerns regarding insurance coverage criteria issues
Follow up on incomplete referral information for services, demographic and payer information to ensure customer needs are met within established guidelines
Required qualifications for this position includes:
High School Diploma -OR- General Education
Current Oregon Board of Pharmacy Technician registration
Two (2) years of experience with insurance verification, medical claims processing, insurance member enrollment or customer service
Two (2) years of experience as a pharmacy technician in a specialty setting (e.g. Long Term Care, Infusion or Specialty Pharmacy)
Three (3) years pharmacy technician experience in an outpatient pharmacy setting
Two (2) years of experience with computers in data entry
Preferred qualifications for this position include:
- Experience using electronic medical records software
About Providence in Oregon
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.
The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,
"Providence will provide the best care and service to every person, every time."
Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.
We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Pharmacy Technician
Req ID: 285990