What are the responsibilities and job description for the Pharmacy Technician- Insurance Authorization position at University Cancer & Blood Center/University Health...?
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At University Cancer & Blood Center, we pride ourselves on listening. On providing hope, guidance, and comfort. On getting up each day and striving to make a positive impact on the lives of patients and their families. From our front-desk staff to our counselors, nurses, technicians and physicians – who’ve chosen to accept their calling, we salute them for their efforts and recognize them as the very special individuals that they are.
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Job Description:
Job Summary: This individual is responsible for processing prescriptions for pharmacy patients. It will also assist the pharmacist and technician in the medically integrated retail pharmacy department within University Cancer & Blood Center, LLC. This individual will assist in the dispensing of commercially available drugs, assist with providing pharmaceutical care to our patients, processing pharmacy claims, assist in filling prescriptions, filing insurance claims, procuring patient assistance, processing prior authorization requests, satellite deliveries, maintaining proper inventory control, following all state/federal guidelines and current USP standards.
Responsibilities include, but not limited to:
Customer Service: The employee presents a polite, considerate, and professional manner to all patients, staff, and support individuals.
Phone
Emails
Messaging
EMR
In person
Software: Competent and knowledgeable in all software systemsUniversity Cancer & Blood Center Electronic Medical Record System
To process fills, deliveries, and patient care.
Pharmacy processing system
To process fills, all data, billing, reports, accounts receivable/payable, and deliveries.
Microsoft software
Authorization portals- Cover My Meds
Third-party portals
Insurance Authorization.
Ensure all state and federal guidelines are followed
Retrieve all patient information
Process new starts
Submit prior authorizations
Document per procedures all authorizations and communications
Keep patients and staff informed
Communicatee all denials with patient management pharmacists
Ensure delivery of medications
Including scheduling/tracking mail order fills
Prescriptions: Assist pharmacist in properly processing prescriptions, adjudicating claims, and appropriately tracking all insurance rejections and approvals.
Process prescriptions via a pharmacy software system
Verify accurate and current information on prescriptions
Completely understand the difference between commercial and government-funded insurance companies and the regulations for both.
Adjudicate claims via a pharmacy software system
Process New start prescriptions and keep patients and appropriate staff informed
Process Injections for all pharmacy patients per the current procedures
Process & Track all insurance rejections and approvals
Maintain proper records and storage of prescriptions
Risk Evaluation and Mitigation Strategies (REMS) programs
Follows current guidelines and protocols for all REMS programs
Faxes:
Maintain HIPAA for all incoming and outgoing faxes
Record and Document all faxes appropriately.
Complies with University Cancer & Blood Center, LLC and departmental policies and procedures.
Maintains professional growth and development, participates in professional affiliations, and reviews applicable, current literature.
Ensures applicable continuing education and licensure are maintained.
Performance Requirements:
Knowledge, Skills, & Abilities:
Management skills
Organizational skills
Knowledge of medical terminology and clinical retail pharmacy operations
Ability and willingness to work with potential exposure to toxic drugs and infectious patients
Ability to operate a computer and various software
Ability to maintain records and files
Ability to work with precision and accuracy
Ability to maintain confidentiality
Education: Minimum high school diploma
Experience: Three years of related experience preferable
Certificate/License: Certified Pharmacy Technician preferred / Georgia Pharmacy Technician License required
