Non-Retail Certified Pharmacy Technician - Intake (Amber Specialty Pharmacy)

Hy-Vee, Inc.•Omaha, NE

2d•$21 - $24•Onsite

About The Position

Amber Specialty Pharmacy is seeking to hire a Certified Pharmacy Technician for the Intake department. This role is responsible for new patient intake, benefits investigation, initiating prior authorizations, and navigating patient access for an assigned product program. The position involves day-to-day customer service activities and support for assigned clients and customers, providing excellent customer service in all interactions. Amber Specialty Pharmacy is a wholly owned subsidiary of Hy-Vee, Inc., specializing in managing rare and chronic conditions and providing comprehensive clinical support and patient management.

Requirements

Current unrestricted state pharmacy technician registration/licensure.
National or state pharmacy technician certification per applicable State Board of Pharmacy requirements.
High school diploma or equivalent.
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 pass post-offer, pre-employment drug background tests as allowed by state, federal, local ordinance, statutes and licensing/accreditation requirements.
Must be able to remain in a stationary position up to 90% of the time.
Must be able 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).
Must lift and traverse the area to move paper and supplies to use the equipment.
Candidates must be able to pass a pre-employment drug test, background check, and health screening (if applicable).

Nice To Haves

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

Responsibilities

Routing all incoming documentation for new patients, refills, and additional documentation for Specialty and Infusion pharmacies per product program requirements.
Prescription entry, requesting new prescriptions, and clarifications from prescribers as supervised by a pharmacist.
Completing benefits investigation, including prior authorization and medical vs pharmacy determination.
Meeting all payer documentation requirements, including Medicare Certificates of Medical Necessity and DME Information Forms.
Navigating and troubleshooting all aspects of patient access for patients within a dedicated product program.
Explaining Company programs and services to Referral sources and provider’s office staff regarding services, shipment contents, and patient rights.
Acting as a liaison between Company, insurance, Pharma, co-pay assistance sources, and provider’s offices via phone, fax, and e-mail communications.
Entering data requirements into tracking software.
Transferring calls to clinical staff for clinical education/assessment activities.
Creating patient’s estimated cost of benefits with all pertinent information and attaching to record for use by customer care center of excellence.
Notifying 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.
Recording and processing orders and/or inquiries received by mail, telephone and/or through direct patient contact.
Maintaining documentation of calls to and from patients, caregivers, insurance, providers, and Pharma.
Creating patient activities as a reminder for tasks such as follow-up calls, clinical assessments, referrals to Case Management, discharge initiation, patient letters, mailings, or other reminders related to the patient’s care.
Collaborating with program team members on other aspects of the product program, including intake and patient access functions and patient communications and onboarding.
Coordinating manufacturer or nursing agency support when home teaching is required.
Maintaining referral log daily and updating with all pertinent information.
Completing patient’s Estimated Cost of Benefits and explaining it to the patient and others in the organization.
Contacting referring nurses/coordinators regarding insurance verification findings, patient issues, and status updates.
Adhering to all company policies.
Reviewing the Policy and Procedure manual.