Specialty Pharmacy Service Representative

Stanford Health Care

Applications Closed

Posted 2 months ago

Full Time

Palo Alto, California

Hybrid

Smart Summary

The Specialty Pharmacy Representative serves as a key point of contact for patients, providing support with prescription management and insurance inquiries. Responsibilities include handling communication, coordinating refills, verifying benefits, and resolving claim issues.

We are looking for a detail-oriented Specialty Pharmacy Service Representative to assist patients with prescription management and insurance inquiries. This role requires a high school diploma or GED, one year of call center or customer service experience, and experience in insurance, medical, or pharmacy environments. Strong communication, problem-solving, and computer skills are essential for success in this fast-paced environment.

Must Have Skills for ATS

Customer Service

Prescription Management

Insurance Verification

Medication Adherence

Data Entry

Record Keeping

Problem Solving

Communication

Interpersonal Skills

Medical Terminology

Regulatory Knowledge

Fast-Paced Environment

Computer Skills

Microsoft Outlook

Microsoft Word

Knowledge of Diseases

Job Description

1.0 FTE   Full time   Day - 08 Hour   R2551703   Hybrid   108390011 Pharmacy OP Specialty 500P   Other   PALO ALTO, 2465 Faber, California

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. 

Day - 08 Hour (United States of America)This is a Stanford Health Care job.

A Brief Overview
The Specialty Pharmacy Representative serves as a key point of contact for patients, providing support with prescription management, insurance inquiries, and medication adherence. Working under direct supervision in a fast-paced environment, this role involves handling high volumes of inbound and outbound communication, coordinating refills and deliveries, verifying benefits, and resolving claim issues. Representatives are also responsible for completing patient registration, maintaining accurate records, documenting interactions, and escalating complex matters to pharmacists or senior staff as needed.

Locations
Stanford Health Care

What you will do
  • Answer patient calls: Address questions about prescriptions, refills, insurance information, and other related topics.
  • Medication Management: Ensure patients remain on track with medication regimen-outbound therapy/medication adherence checkups; secures refill prescriptions. Contacts clients to schedule deliveries, confirm address, inform them of any financial responsibility.
  • Troubleshooting and resolving issues: Assisting with claim rejections, verifying insurance information, and helping with program eligibility.
  • Data entry and record-keeping: Updating patient information, documenting calls, and maintaining records.
  • Escalating complex issues: Provides assistance to Pharmacists, both those in the facility and those at other locations. Identifies and communicates issues to senior level staff as appropriate.
  • Providing customer service: Communicates with clients as needed regarding the fulfillment of prescription refills and refers any health-related concerns to a healthcare professional when required.
  • Following company procedures: Adhering to established protocols and guidelines for handling calls and resolving issues.
  • Maintaining confidentiality: Ensuring the privacy and security of patient information.
  • Performs other duties and responsibilities as assigned.

Education Qualifications
  • High school diploma or general education degree (GED)

Experience Qualifications
  • One year minimum call center experience, or other related experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.
  • Experience in insurance, medical, or pharmacy environments is required.

Required Knowledge, Skills and Abilities
  • Ability to adapt to and deal with change and ambiguity.
  • Ability to plan, organize, prioritize, work independently and meet deadlines.
  • Ability to solve problems and identify solutions.
  • Ability to speak and write effectively at a level appropriate for the job.
  • Ability to work effectively with individuals at all levels of the organization.
  • Ability to work in a fast-paced work environment.
  • Knowledge of local, state and federal regulatory requirements related to areas of functional responsibility.
  • Knowledge of Medical terminology and abbreviations; and disease states.
  • Strong interpersonal communication skills.
  • Knowledge of computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications.
  • Knowledge of Microsoft Outlook and Word.
  • Knowledge of inflammatory diseases, infectious disease, and/or oncology.


These principles apply to ALL employees:

SHC Commitment to Providing an Exceptional Patient & Family Experience

Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.

You will do this by executing against our three experience pillars, from the patient and family’s perspective:
  • Know Me: Anticipate my needs and status to deliver effective care
  • Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health
  • Coordinate for Me: Own the complexity of my care through coordination

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

Base Pay Scale: Generally starting at $31.30 - $35.25 per hour

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.

Stanford Health Care

Stanford Health Care, with multiple facilities throughout the Bay Area, is internationally renowned for leading edge and coordinated care in cancer care, neurosciences, cardiovascular medicine, surgery, organ transplant, medicine specialties, and primary care. Throughout its history, Stanford has been at the forefront of discovery and innovation, as researchers and clinicians work together to improve health, alleviate suffering, and translate medical breakthroughs into better ways to deliver patient care. Stanford Health Care: Healing humanity through science and compassion, one patient at a time. At Stanford Health Care, your career is supported within a distinctive hospital culture. This environment compliments the pioneering, collaborative atmosphere that has earned us our worldwide reputation for excellence.

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