Dedicated Certified Pharmacy Technician - Intake (FT)

Hy-Vee, Inc.•Omaha, NE

1d•Onsite

About The Position

At Amber Specialty Pharmacy, our commitment to patient care is unmatched. Enjoy fulfillment in a career where you have the opportunity to make a positive impact on patients with complex and chronic conditions. Amber Specialty Pharmacy, a wholly owned subsidiary of Hy-Vee, Inc., stands at the forefront of healthcare innovation, headquartered in Omaha and serving patients nationwide. This role is responsible for new patient intake, benefits investigation, initiating prior authorizations, and navigating patient access for an assigned product program. It also involves day-to-day customer service activities and support of assigned clients and customers, providing excellent customer service in all interactions.

Requirements

Proficient with MS Excel, Word, and Outlook
Demonstrated ability to meet tight deadlines
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
Must be knowledgeable in Medicare, Medicaid, Commercial insurance, and renal programs and how they apply to transplant and specialty patients
Knowledgeable in the process of insurance verification and online prescription adjudication
High school diploma or equivalent
Current unrestricted state pharmacy technician registration/licensure
National or state pharmacy technician certification per applicable State Board of Pharmacy requirements
Must pass post-offer, pre-employment drug background tests as allowed by state, federal, local ordinance, statutes and licensing/accreditation requirements.

Nice To Haves

Working knowledge of Medicare, Medicaid, and Commercial Insurance related to pharmacy billing, prior authorizations, insurance verification, and medical terminology preferred

Responsibilities

Responsible for routing all incoming documentation for new patients, refills, and additional documentation for Specialty and Infusion pharmacies per product program requirements.
Responsible for prescription entry, requesting new prescriptions, and clarifications from prescribers as supervised by a pharmacist.
Must be able to complete benefits investigation, including prior authorization and medical vs pharmacy determination.
Must also meet all payer documentation, 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.
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, insurance, 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 providers or patients 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, insurance, providers, and Pharma.
Creates patient activities as a reminder for the following tasks, including, but not limited to, follow-up calls, clinical assessments, referrals to Case Management, discharge initiation, patient letters, mailings, or other reminders related to the patient’s care.
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.
Responsible for coordinating manufacturer or nursing agency support when home teaching is required.
Must maintain referral log daily and update with all pertinent information.
Responsible for completing patient’s Estimated Cost of Benefits and able to explain to patient and others in the organization.
Contacts referring nurses/coordinators according to the assigned team regarding insurance verification findings and patient issues, and status updates.
Adheres to all company policies as indicated in the handbook and directives issued by management.
Has reviewed the Policy and Procedure manual.