Emilie Coby

• Manage inbound calls and provide excellent customer service to patients.
• Navigate multiple computer systems to respond to inquiries of providers, patients, and internal consumers.
• Set up shipments of medication for patients over the phone using Scriptmed.
• Use of Excel spreadsheet to keep track and follow up on patients.
• Reorder, reprocess prescriptions, making sure the directions, quantity, and need date matches the image on file in Scriptmed.
• Input data demographics for new patients.

• Manage inbound calls and provide excellent customer service to patients.
• Data entry.
• Stocking.
• Inventory.
• Filling prescriptions.
• Initiating prior authorizations.
• Clean and maintain work area.
• Processing insurance and workers compensation claims.

• Answer inbound and/or outbound patient and pharmacy calls
• Call patients to schedule and complete medication refills
• Help process prescriptions and resolve claim issues
• Check prescription status and update patient records
• Work with pharmacists and providers to clarify orders
• Provide friendly, helpful support to patients and partners
• Use systems to track work and keep information up to date
• Other duties and/or responsibilities may apply

• Accurately filling prescriptions, including verifying patient information, calculating dosages, and labeling medications according to 340B guidelines.
• Maintaining accurate inventory levels of 340B medications, including regular stock checks, ordering, and rotation to prevent expiration.
• Recording and reporting relevant 340B data such as drug purchase details, patient demographics, and dispensing information to ensure program compliance.
• Staying updated on 340B regulations and ensuring all pharmacy practices adhere to program requirements.
• Answering basic medication-related questions from patients and providing information regarding 340B eligibility.
• Assisting with the billing process for 340B medications, ensuring accurate claim submissions.
• Generating reports on 340B drug utilization, cost savings, and indentifying potential compliance issues.

• Performs All duties defined by standard work or other guidelines communicated by leadership under their direct supervision of a licensed pharmacist.
• Operates computer systems to accurately input medication orders and obtain necessary patient information.
• Assists in maintaining pharmacy inventory and record keeping in accordance with state and federal law. Reports medication errors on a continuous basis.
• Assures timely distribution of prescribed medications and stock items as needed.
• Utilizes effective listening and communication skills. Maintains supervisor awareness of personal and team activities affecting the department. Exhibits proactive problem solving to address issues impacting departmental services.
• Maintains a plan for personal goal setting and ongoing development of team members.
• Shares expertise by participating in the orientation and education of pharmacy employees and students.

• Prep, review and approve / deny requests for prescription prior authorization and / or appeal.
• Scan, index and prepare documents related to prior authorization and / or appeal request, verifying and updating patient / member profile information.
• Compile medical notes (disease state, drug treatment history and current drug plan) from patient / provider in support of the request, review request against decision tree and approval protocol, perform outreach for additional information as needed to support the request.
• Update approved requests in claims systems and inform patient / provider of approval.
• Forward applicable requests through additional review path as needed.
• Ensure Rx denial is communicated to patient / provider along with rationale. Verify appropriate Member and Provider information.
• Contact Pharmacists, and Doctor's offices to resolve Claims issues.
• Consistently meet established productivity, schedule adherence, and quality standards while maintaining a good attendance record.
• Outreach will be performed via phone and electronically (e.g. fax)
• Accurate, timely, and detailed documentation of each Outreach attempt.
• Collaborate with Pharmacists and Medical Directors, ensuring coverage criteria is clearly communicated to the Physicians and their office personnel.
• Provider Outreach to obtain additional information necessary for the Pharmacist or Medical Director to render a coverage decision.
• Update and effectuate approved appeal requests in pharmacy claims systems.

• Prep, review and approve / deny requests for prescription prior authorization and / or appeal.
• Scan, index and prepare documents related to prior authorization and / or appeal request, verifying and updating patient / member profile information.
• Compile medical notes (disease state, drug treatment history and current drug plan) from patient / provider in support of the request, review request against decision tree and approval protocol, perform outreach for additional information as needed to support the request.
• Update approved requests in claims systems and inform patient / provider of approval.
• Forward applicable requests through additional review path as needed.
• Ensure Rx denial is communicated to patient / provider along with rationale. Verify appropriate Member and Provider information.
• Contact Pharmacists, and Doctor's offices to resolve Claims issues.
• Consistently meet established productivity, schedule adherence, and quality standards while maintaining a good attendance record.
• Outreach will be performed via phone and electronically (e.g. fax)
• Accurate, timely, and detailed documentation of each Outreach attempt.
• Collaborate with Pharmacists and Medical Directors, ensuring coverage criteria is clearly communicated to the Physicians and their office personnel.
• Provider Outreach to obtain additional information necessary for the Pharmacist or Medical Director to render a coverage decision.
• Update and effectuate approved appeal requests in pharmacy claims systems.
• Requires little assistance with standard and non-standard requests
• Prioritizes and organizes own work to meet agreed upon deadlines
• Resolve customer service inquiries which could include:
• Benefit and Eligibility information
• Billing and Payment issues
• Customer material requests
• Physician assignments
• Authorization for treatment
• Explanation of Benefits (EOB)
• Provide excellent customer service

• Complete prescription intake process including verification of insurance coverage.
• Assist physician’s offices through the prior authorization and appeals process.
• Research financial assistance options for patients through copay cards, foundations, and assistance programs.
• Coordinate prescription processing and delivery with dispensing pharmacies.
• Manage and triage high volume of customer service phone calls while managing day to day operations.
• Build relationships with physicians, manufacturer sales representatives, pharmacies, patients, and other team members to optimize workflow and achieve program goals.
• Ensure proper documentation of process flow from prescription initiation through completion.
• Provide timely updates to physicians, pharmacies, and manufacturers regarding prescription status.
• Interface with IT department to improve system functionality and workflow.
• Attend team meetings to support ongoing program development.

• Manage inbound calls and provide excellent customer service to patients.
• Navigate multiple computer systems to respond to inquiries of providers, patients, and internal consumers.
• Set up shipments of medication for patients over the phone using Scriptmed.
• Collect payment information to add into Scriptmed.
• Use of Excel spreadsheet to keep track and follow up on patients.
• Reorder, reprocess prescriptions, making sure the directions, quantity, and need date matches the prescription image on file in Scriptmed
• Input data demographics for new patients.
• Writing internal and external error reports.
• Handling delivery issues, including tracking packages and escalating delivery issues to the proper department.
• Imaging in new prescriptions.
• Processing insurance claims.
• Processing and charging payments.
• Entering and typing in prescriptions.

• Manage inbound calls and provide excellent customer service to patients.
• Data entry.
• Stocking.
• Inventory.
• Filling prescriptions.
• Initiating prior authorizations.
• Clean and maintain the work area.
• Processing insurance and workers compensation claims.
• Implemented necessary changes based on the evaluation of staffing requirements and floor assignments.
• Ensure hippa compliance.
• Trained new staff on quality control procedures.