Pharmacy Technician Specialty
US-IA-Urbandale
careers
Req #: 170889
Type: Full Time Benefits
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Overview: Full Time; Monday - Friday; 8:00am - 5:00pm Receives and processes prescription referrals received by the Specialty Pharmacy including data entry, insurance processing, and prior authorization completion for specialty medications. Understands pharmacy benefit and medical benefit claims submission process for reimbursement of prescription medications. Communicates with patients/caregivers, insurance company representatives, and other members of the healthcare team for patients to initiate and continue therapy. Responsibilities: * Looks at the individual needs of each patient/customer and matches those needs to the many services UnityPoint at Home has to offer; utilizes other members of the home care coordination team as necessary to coordinate services outside of the specialized service line. * Processes all incoming prescription orders; obtains demographic, financial, and other qualifying data to verify benefits and obtain authorization for specialty medications. * Processes test claims of health system's specialty pharmacy prescriptions through pharmacy dispensing software to determine available pharmacy options through patient insurance plans. * Communicates/coordinates with patients/caregivers and members of the healthcare team appropriate actions based on patients' benefits. * Specializes in specialty pharmacy service line yet is responsible for having a basic knowledge of all service lines. * Initiates and coordinates prior authorization requests to third party payers and maintains a working knowledge of third-party payer guidelines. Follows up with third party payers as necessary. * Collects insurance information, runs test claims, obtains medical records as required for completion of prior authorizations. * Re-verifies eligibility and benefits when patient starts a new benefit year. 90% * Provides customer service to patients and physicians' offices and coordinates the delivery of medications with patients/caregivers and/or members of the healthcare team via inbound and outbound calls, email, and other electronic messaging. Operates pharmacy dispensing software and health system electronic health record to record, document, and retrieve pertinent medical information within the patients' electronic medical record to ensure appropriate agency services are provided in a timely manner. Establishes and maintains positive working relationships with current and potential providers and referral sources. Upholds expectations and perceptions of UPAH as a high-quality provider of services by maintaining excellent customer service. Maintains a working knowledge of relevant regulations affecting patients and the operation of our business. Performs patient follow up phone calls as directed by manager or supervisor. On-call duties may be required on a rotation basis, including weekends and holidays. Prohibited from conducting evaluations or interpreting any clinical decision. Refers clinical questions to appropriate staff. Qualifications: Education: High school diploma or equivalent Experience: One year of medical experience; preferably in community home health or pharmacy License(s)/Certification(s): Nationally certified pharmacy technician registered with the Iowa Board of Pharmacy as a Certified Pharmacy Technician (or registered as technician trainee if not yet certified) Registered Pharmacy Support Valid driver's license when driving any vehicle for work-related reasons
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