Order Entry Tech - Pharmacy Tech - LifeSpan Pharmacy

CarDon & Associates•Indianapolis, IN

About The Position

LifeSpan Pharmacy, a CarDon & Associates partner, is now seeking a Order Entry Tech. EDUCATION, QUALIFICATIONS, CREDENTIALS: Must hold a Pharmacy Tech License Associate degree in health-related field or 1-2 years direct work experience in health related field Understanding of Medicare/Medicaid/Insurance Pay types, medical terminology, and brand/generic medications required Working knowledge of Microsoft Word and Excel, or like applications RESPONSIBLE TO: Operations Manager ESSENTIAL FUNCTIONS: I. Prescription processing (80%) Data Entry of new and refill orders which includes: 1. Interprets prescription directions, including the clarification and communication to the facility when necessary 2. Identifies orders that cannot be processed due to coverage issues, missing information, or inability to read/understand 3. Inputs medication orders with correct medication and frequency. Minimum requirement is 30 orders per hour. 4. Ensures formulary substitutions are made appropriately based on facility contracts 5. Completes appropriate paperwork/forms, as well as communicating order exceptions and any other discrepancies to facilities and team leaders 6. Transmit all third party and Medicaid online claims at time of order entry to ensure payment as well as dispensing fee. 7. Maintains an understanding of the special requirements for each payer including Medicare/Managed Care/Medicaid Formulary and Non-Formulary/Third Party Insurance as well as communicate discrepancies to facilities regarding: Formularies Rejections Contract requirements Exclusions and Non-covered medications 8. Adherer to special Facility processing requirements (i.e. House Stock, Non-covered Medication Policies) 9. Researches and communicates with facility regarding any processing and reimbursement issues with order II. Admission/Readmission of residents to Pharmacy System (15%) Process new admission/readmission information for residents: 1. Reviews admissions and enters correct admission pay type information into Pharmacy system calling facility when pay type information not available 2. Collects information from facilities regarding resident insurance cards, social security number, guarantor demographics, room number, wing, allergies, diagnosis, verifies patient medication needs, etc. 3. Verifies Insurance/Medicaid eligibility 4. Identifies orders that cannot be processed due to coverage issues, missing information, or inability to read/understand 5. Communicates with facility and Third-party providers to get necessary coverage, missing information etc. to correct order to be processed 6. Input of medication orders with correct medication and frequency 7. Ensures formulary substitutions are made appropriately based on facility and third-party provider contracts 8. Completes appropriate paperwork/forms, as well as communicating order exceptions and any other discrepancies to facilities, third party providers, and team leaders 9. Transmit all third party and Medicaid online claims at time of order entry to ensure payment as well as dispensing fee. 10. Documents all admits/readmits processed on the admission log III. General Office (5%) Attends training as provided for self-improvement and quality of work Accepts other duties as assigned Supports Skilled Care's Mission and high standard of customer care The preceding list of essential functions is not exhaustive and may be supplemented. KNOWLEDGE, SKILLS, AND ABILITIES: Demonstrate superior customer service skills Ability to interact with all levels of department representatives both internally and externally Ability to exhibit effective verbal and written communication skills Maintains high level of attendance and punctuality Communicates in a positive and respectful manner with customers and internal team members Generates and supports ideas to improve service to internal and external customers Resolves conflict in a positive manner

Requirements

Must hold a Pharmacy Tech License
Associate degree in health-related field or 1-2 years direct work experience in health related field
Understanding of Medicare/Medicaid/Insurance Pay types, medical terminology, and brand/generic medications required
Working knowledge of Microsoft Word and Excel, or like applications
Demonstrate superior customer service skills
Ability to interact with all levels of department representatives both internally and externally
Ability to exhibit effective verbal and written communication skills
Maintains high level of attendance and punctuality
Communicates in a positive and respectful manner with customers and internal team members
Generates and supports ideas to improve service to internal and external customers
Resolves conflict in a positive manner

Responsibilities

Data Entry of new and refill orders
Interprets prescription directions, including the clarification and communication to the facility when necessary
Identifies orders that cannot be processed due to coverage issues, missing information, or inability to read/understand
Inputs medication orders with correct medication and frequency. Minimum requirement is 30 orders per hour.
Ensures formulary substitutions are made appropriately based on facility contracts
Completes appropriate paperwork/forms, as well as communicating order exceptions and any other discrepancies to facilities and team leaders
Transmit all third party and Medicaid online claims at time of order entry to ensure payment as well as dispensing fee.
Maintains an understanding of the special requirements for each payer including Medicare/Managed Care/Medicaid Formulary and Non-Formulary/Third Party Insurance as well as communicate discrepancies to facilities regarding Formularies, Rejections, Contract requirements, Exclusions and Non-covered medications
Adherer to special Facility processing requirements (i.e. House Stock, Non-covered Medication Policies)
Researches and communicates with facility regarding any processing and reimbursement issues with order
Process new admission/readmission information for residents
Reviews admissions and enters correct admission pay type information into Pharmacy system calling facility when pay type information not available
Collects information from facilities regarding resident insurance cards, social security number, guarantor demographics, room number, wing, allergies, diagnosis, verifies patient medication needs, etc.
Verifies Insurance/Medicaid eligibility
Communicates with facility and Third-party providers to get necessary coverage, missing information etc. to correct order to be processed
Ensures formulary substitutions are made appropriately based on facility and third-party provider contracts
Documents all admits/readmits processed on the admission log
Attends training as provided for self-improvement and quality of work
Accepts other duties as assigned
Supports Skilled Care's Mission and high standard of customer care