We are searching for a pharmacy technician for our intake department. No nights, weekends, and all major holidays off. This is a Monday-Friday position with daytime hours.
- Under the supervision of the pharmacist, assists in the practice of pharmacy, in accordance with state, federal and Company policy.
- Operates pharmacy systems and software in order to obtain patient and drug information, process prescriptions, and perform other necessary functions on the system in accordance with policies and regulations.
- Reviews and researches invalid prescriptions to determine needed information.
- Responsible for routing all incoming documentation for new patients, refills and additional documentation for Specialty and Infusion pharmacy.
- Responsible for prescription entry and requesting new prescriptions and clarifications from prescribers as supervised by a pharmacist.
- Explains all company programs and services to referral sources and provider’s office staff regarding what to expect with company services, contents of shipments and patient rights.
- Acts as a liaison between Company, insurances, Pharma, co-pay assistance sources and provider’s offices via phone, fax and e-mail communications.
- Enters data requirements into tracking software. Transfers call to clinical staff for clinical education/assessment activities.
- Creates patient’s estimated cost of benefits with all pertinent information and attaches to record for use by customer care center of excellence.
- Notifies appropriate staff of relevant information gathered during calls to provider or patient that may affect a patient’s disease state, medication regimen or method of funding.
- Records and processes orders and/or inquiries received by mail, telephone and/or through direct patient contact.
- Maintains documentation of calls to and from patients, caregivers, insurances, providers and Pharma.
- Creates patient activities as a reminder for the following tasks including, but not limited to, follow-up calls, clinical assessments, and referrals to Case Management, initiation of discharge, patient letter mailings, or other reminders as it relates to the patient’s care.
- Must maintain the established workflow within the Patient Access Intake Department and adhere to the company/department’s Policy and Procedure manual.
- Responsible for coordinating manufacturer or nursing agency support when a home teaching is required.
- Must maintain referral log on a daily basis and update with all pertinent information.
- Responsible for completing patient’s Estimated Cost of Benefits and able to explain to patient and others in organization.
- Must be able to perform complete benefits investigation, including prior authorization and medical vs pharmacy determination. The individual will also need to complete all payer documentation including Medicare Certificates of Medical Necessity and DME Information Forms.
- Contacts referring nurses/coordinators according to assigned team regarding insurance verification findings and patient issues and status updates.
- Ability to work with all levels of internal management and staff, as well as outside clients and vendors
- Working knowledge of Medicare, Medicaid and Commercial Insurance related to pharmacy billing, prior authorizations, insurance verification, and medical terminology preferred
- Must be knowledgeable in Medicare, Medicaid, Commercial insurances, and renal programs and how they apply to transplant and specialty patients.
- Knowledgeable in the process of insurance verification and online prescription adjudication.
- Working knowledge of the healthcare industry
- HIPAA trained and /or the ability to work with and protect extremely confidential patient and employee information
- Six months or less of similar or related work experience
Licensure and Certification Requirements:
- Certified as a licensed technician through a certified national program and maintains continuing education requirements to keep certification active in states where certification is required.
- Current unrestricted state registration.
- Certification upon hire or within state-specific guidelines.
- Completes additional state registrations as requested.
- Nationally Certified Pharmacy Technician a plus
Paid time off