Certified Pharmacy Technician - Intake (FT)

Primary Duties and Responsibilities:

• Responsibleforroutingallincomingdocumentationfornewpatients,refills,andadditional documentation for Specialty and Infusion pharmacies per product program requirements.

• Responsibleforprescriptionentry, requesting new prescriptions,andclarificationsfromprescribersas supervised by a pharmacist.

• Must beableto completebenefitsinvestigation, including prior authorizationand medical vs pharmacydetermination.Theindividualmust alsomeetallpayerdocumentation,including Medicare Certificates of Medical Necessity and DME Information Forms.

• Responsible for navigating and troubleshooting all aspects of patient access to all patients within a dedicated product program.

• ExplainsallCompanyprogramsandservicestoReferralsourcesandprovider’sofficestaffregardingwhat to expect with Company services, contents of shipments, and patient rights.

• ActsasaliaisonbetweenCompany,insurance,Pharma,co-payassistancesources,andprovider’soffices via phone, fax, and e-mail communications.

• Entersdatarequirementsintotrackingsoftware.Transferscalltoclinicalstaffforclinical education/assessment activities.

• Createspatient’sestimatedcostofbenefitswithallpertinentinformationandattachestorecordforuse by customer care center of excellence.

• Notifiesappropriatestaffofrelevantinformationgathered duringcallstoprovidersorpatientsthatmay affect a patient’s disease state, medication regimen, or method of funding.

• Recordsandprocessesordersand/orinquiriesreceivedbymail,telephoneand/orthroughdirectpatient contact.

• Maintainsdocumentationofcallstoandfrompatients,caregivers,insurance,providers,andPharma.

• Createspatient activitiesasa reminder for thefollowing tasks,including, but not limited to, follow-up calls, clinical assessments, referrals to Case Management, discharge initiation, patient letters, mailings, or other reminders relatedtothepatient’scare.

• Collaborates with program team members on other aspects of the product program, not limited to intake and patient access functions and patient communications and onboarding.

• Responsibleforcoordinatingmanufacturerornursingagencysupportwhenhometeachingis.

• Must maintain referral log daily and update with all pertinent information.

• Responsibleforcompletingpatient’sEstimatedCostofBenefitsandabletoexplaintopatientandothers in the organization.

• Contactsreferringnurses/coordinatorsaccordingtothe assignedteamregardinginsuranceverification findings and patient issues, and status updates.

• Adherestoallcompanypoliciesasindicatedinthehandbookanddirectivesissuedbymanagement.Has reviewed the Policy and Procedure manual.

Professional Competencies:

• Proficient with MS Excel, Word, and Outlook

• Demonstratedabilitytomeettightdeadlines

• Must be detail oriented with a high level of accuracy

• Ability to work with all levels of internal management and staff, as well as outside clients and vendors

• WorkingknowledgeofMedicare,Medicaid,andCommercialInsurancerelatedtopharmacybilling,prior authorizations,insuranceverification,andmedicalterminologypreferred

• MustbeknowledgeableinMedicare,Medicaid,Commercialinsurance,andrenalprogramsandhowthey apply to transplant and specialty patients

• Knowledgeable in the process of insurance verification and online prescription adjudication

Educational and Experience Requirements:

• High school diploma or equivalent

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Licensure and Certification Requirements:

• Current unrestricted state pharmacy technician registration/licensure 

• National or state pharmacy technician certification per applicable State Board of Pharmacy requirements

Physical Requirements:

• Must be able to remain in a stationary position up to 90% of the time

• The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc., and traverse conferences, meetings, and remote events

• Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer

• The ability to communicate information and ideas so others will understand. Must be able to exchange accurate information in these situations

• The ability to observe details at close range (within a few feet of the observer)

Working Conditions:

Normal office environment.

Equipment Used to Perform the Job:

Computers, keyboards, mouse, monitors, fax, and/or headsets for phone work. Software specific to the position, including but not limited to Microsoft Outlook and Skype. Must lift and traverse the area to move paper and supplies to use the equipment.

Contacts:

Frequently interact with co-workers, intradepartmental staff of the Company, managers, leaders, Vendors, and customers.

Confidentiality:

The position Interactions with medical personnel and patients and accesses proprietary and medical (HIPAA) information in various interactions and matters.