Pharmacy Coordinator - Specialty Pharmacy

Employment Status:

Full time

Shift:

Any Day, Any Shift (United States of America)

Facility:

4336 Electric Rd- Roanoke

Requisition Number:

R160100 Pharmacy Coordinator- Specialty Pharmacy (Open)

How You’ll Help Transform Healthcare:

The Specialty Pharmacy Coordinator provides specialty pharmacy intake, insurance verification, prior authorization, and reimbursement support for complex and high-cost medications. This role works collaboratively with patients, pharmacists, providers, and clinical teams to ensure required documentation, coverage determination, and financial assistance processes are completed to support timely initiation and continuation of therapy. The Coordinator independently manages assigned patient cases while delivering high-quality customer service and maintaining accurate documentation within specialty pharmacy systems.

The Specialty Pharmacy Coordinator

• Provides initial patient onboarding and account setup for specialty pharmacy services, including intake of referrals, therapy changes, and service requests.

• Enters, updates, and maintains accurate patient, insurance, benefits, and authorization data in pharmacy and care management systems.

• Communicates with patients throughout onboarding and therapy to obtain required information, explain processes, and provide status updates.

• Conducts insurance, benefits, and financial investigations to determine coverage, prior authorization, and reimbursement requirements.

• Completes initial and renewal prior authorization submissions and tracks approval status.

• Communicates approvals, denials, delays, and next steps to patients, providers, pharmacists, and internal teams.

• Identifies patient financial assistance needs and facilitates enrollment in copay, manufacturer, or patient assistance programs.

• Collaborates with pharmacists and providers to obtain clinical documentation and letters of medical necessity.

• Assists patients with billing questions, outstanding balances, and payment arrangements in accordance with established guidelines.

• Responds to incoming phone calls and electronic communications and resolves customer inquiries and concerns.

• Runs and reviews standard departmental reports to support audit, compliance, and revenue monitoring.

• Identifies opportunities for workflow efficiency and process improvement within assigned responsibilities.

• Maintains confidentiality and complies with regulatory, accreditation, and organizational requirements.

What We Require:

Education: High school diploma or equivalent required.

Experience: Minimum of 3 years of pharmacy or healthcare revenue cycle experience

Licensure, Certification, and/or Registration: Virginia Board of Pharmacy registration. Certified Pharmacy Technician (CPhT) required

Other Minimum Qualifications: Knowledge of government and commercial insurance, specialty pharmacy workflows, strong customer service, problem-solving, and system proficiency

This job description is only meant to be a representative summary of the major responsibilities and accountabilities performed by the incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

Recruiter:

MARK MISKOVIC

Recruiter Email:

mamiskovic@carilionclinic.org

For more information, contact the HR Service Center at 1-800-599-2537.

Carilion Clinic is an Equal Opportunity Employer: We provide equal employment opportunities to all employees and applicants without regard to race, color,  religion, sex, national origin, age (40 or older), disability, genetic information, or veterans status. Carilion is a Drug-Free Workplace. For more information or for individuals with disabilities needing special assistance with our online application process contact Carilion HR Service Center at 800-599-2537, 8:00 a.m. to 4:30 p.m., Monday through Friday.

For more information on E-Verify: https://www.carilionclinic.org/eoe-e-verify-and-right-work-policies

Benefits, Pay and Well-being at Carilion Clinic

Carilion understands the importance of prioritizing your well-being to help you develop and thrive.  That’s why we offer a well-rounded benefits package, and many perks and well-being resources to help you live a happy, healthy life – at work and when you’re away.

When you make your tomorrow with us, we’ll enhance your potential to realize the best in yourself. Below are benefits available to you when you join Carilion:

• Comprehensive Medical, Dental, & Vision Benefits
• Employer Funded Pension Plan, vested after five years (Voluntary 403B)
• Paid Time Off (accrued from day one)
• Onsite fitness studios and discounts to our Carilion Wellness centers
• Access to our health and wellness app, Virgin Pulse
• Discounts on childcare
• Continued education and training