Outreach Eligibility Specialist

Job Purpose:

• Proactively grow the specialty pharmacy patient population by identifying patients that are eligible to fill with a Shields Partner Pharmacy.

• Complete patient benefits investigations.

• Protect Shields values by keeping information confidential.

Job Duties:

• Perform benefits investigation.

• Utilize multiple approved tools to identify insurance coverage.

• Research within patients’ medical records for current medication regimen.

• Complete benefits investigation with approved Pharmacy Dispensing Systems.

• Document clearly and concisely all outcomes of benefits investigation in documentation tool.

• Collaborate with team members to provide an integrated approach of quality patient care.

• Apply observations and recommendations to operational issues, increased productivity, quality, and customer-service standards.

• Identify trends, resolve problems; recommend improvements; implement change.

• Actively participate in process improvement initiatives.

• Act as a value-added business partner to stakeholders throughout the organization.

• Protect organization’s values by keeping information confidential.

• Update job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional or