Shields Health Solutions

    Patient Engagement Specialist

    Shields Health Solutions
    Posted 12/5/2025Entry Level
    Full-time
    Healthcare
    Interpersonal Communication
    Phone Skills
    Patient Engagement
    Data Entry
    Pharmacy Claims Adjudication

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    Job Description

    Patient Engagement Specialist Location: Remote (Candidates located in Pacific or Mountain Time Zones preferred)

    Job Description:

    The Patient Engagement Specialist will be responsible for providing service for inbound pharmacy phone calls and/or placing outbound patient refill calls and assisting the patient through the entire refill process. This role will be responsible for some or all of the below types of activities: responding to patient requests and inquiries regarding prescription drug plan coverage and fulfillment through the pharmacy; inbound calls to support the health systems needs in patient; status checks on prescriptions; assists pharmacies to properly adjudicate electronic prescription drug claims and resolve adjudication error messages; responsible for providing knowledgeable and courteous customer assistance and response to members, providers, and pharmacy team member inquiries; serves as a point of contact between patients, pharmacy, liaisons, clinical providers, and various internal functional areas.

    Key Responsibilities:

    Proactively coordinate medication refills including data entry and pharmacy claim adjudication

    • Make outbound patient refill phone calls and complete the patient refill request.
    • Answer, resolve and triage inbound inquiries.
    • Clarify prescription orders with pharmacist and/or clinician as appropriate.
    • Identify medications requiring special storage and/or handling such as hazardous medications and/or refrigerated medication.
    • Manage, organize, and update relevant data using database applications.
    • Apply observations and recommendations to operational issues, increased productivity, quality, and customer-service standards.
    • Identify trends, resolves 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 value by keeping information confidential. Update knowledge by participating in educational opportunities; reading professional publications; maintaining networks; participating in professional organizations Flexible scheduling to meet business needs with health system partners starting as early as 7:45 AM (EST)/ 8am EST Other duties and/or responsibilities may apply

    Experience/Requirements:

    Required Licensure/Certification: We are seeking experienced pharmacy technicians who are state registered as a pharmacy technician. Nationally certified as a CPhT or equivalent is strongly preferred but not required. Should additional licensure need to be obtained, the applicant will commit to obtaining the required licensure within a mutually agreed upon timeframe. Continued employment is contingent upon meeting these requirements. *If the candidate's state of residence does not have a state registration available, then the National certification is required at time of hire. Should additional licensure need to be obtained, the applicant will commit to obtaining the required licensure within a mutually agreed upon timeframe. Continued employment is contingent upon meeting these requirements.

    Experience and Education Requirements:

    1-3 years of Pharmacy Technician and adjudicating claims experience strongly preferred but not required - managing refills, specialty pharmacy, working with clinical care teams, and working remotely Education: High school diploma or GED required Skills: Strong interpersonal communication skills, exceptional phone skills, comfortable with proactively engaging patients telephonically, comfortable reaching out to on-site clinicians, payors, and pharmacies telephonically, highly proficient in Microsoft Office particularly Excel and Word; able to quickly learn other programs, adapt to Shields’ unique model / tools and able to extract relevant information; strong organizational skills a must Traits: Organized, high-integrity, high accountability, attention to detail, dependable, quality focus, empathetic, good listener/communicator, collaborative, consistently arrives to work on-time with minimal unscheduled time off Other: Energetic, highly motivated, team player with strong personal and communication skills, ability to sit and/or stand with focus at a workstation for a long period of time; discretion and confidentiality essential as position deals with highly sensitive and private data

    Minimum Remote Role Expectations:

    Remote role requires to be sitting at desk with two company required monitors Must have high speed, stable, and reliable internet connection (remote roles are not suitable to people that do not have consistent high speed reliable connection) Must be willing able to work overtime to support week to week fluctuations in patient care management Must have a distraction free work environment where you are able to keep your primary focus on patient care throughout the day (including but not limited to background noises or other distractions in your remote location) Ability camera on for most meetings with co-workers or leaders California residents employed by or applying for work at Shields have certain privacy rights. Please review our: California Workforce Privacy Notice and Privacy Policy. By providing your mobile number, you agree to receive text messages from Shields Health Solutions related to job opportunities, interview scheduling, and recruiting updates. Message and data rates may apply. You may opt out at any time by replying 'STOP.' Consent is not a condition of employment. Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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