Pharmacy Care Tech

OneOncology•Nashville, TN

About The Position

The Certified Pharmacy Care Technician is responsible for customer service and order entry functions to meet customer demands in compliance with Board of Pharmacy, Federal, DEA, accreditation, and other regulatory requirements. The role focuses on medication adherence and coordination among patients, insurance providers, patient assistance programs, and clinic staff. The technician processes prescriptions and claims, supports patients with medication access and delivery, coordinates with external specialty pharmacies, and works across multiple computer systems. They also conduct patient outreach to assess adherence, document and reconcile data, triage communications, and connect patients with pharmacists for medication-related questions.

Requirements

At least 3 years of retail experience or 2 years of experience in a specialty pharmacy environment.
Active Tennessee State Pharmacy Technician license in good standing, or obtain one within 90 days of hire if not previously licensed in Tennessee.
Active pharmacy technician certification from an accredited body, in good standing.
Ability to manage time to meet daily deadlines.
Ability to follow instructions and procedures.
Adaptability to variations in workload.
Ability to multitask while maintaining accuracy and proficiency.
Ability to critically analyze situations and independently identify possible solutions.
Data-entry skills and basic computer proficiency.
Ability to work independently and cooperatively in a team environment.
Effective, professional communication skills and active listening.
Ability to identify and integrate traditional and/or digital solutions into the patient experience to facilitate therapy adherence.
Physical requirements include standing, walking, sitting, fingering or manual dexterity, repetitive finger motion, lifting or exerting force up to 25 pounds, reaching or stretching, climbing or balancing, crouching or stooping, speaking, hearing, and seeing with correction.

Responsibilities

Perform insurance verification, order entry, and prescription processing from multiple modalities.
Review prescriptions for accuracy and completeness.
Follow procedures and scripts during patient engagement.
Determine single- or multiple-prescription needs based on dosage formulation availability.
Onboard new patients.
Set up and verify medication deliveries.
Coordinate prescription orders sent to external specialty pharmacies.
Process specialty claims, including prior authorizations, rejections, copay cards, and overrides.
Process commercial, Medicare Part D, and Medicare Part B claims, including supplemental claims.
Identify and match claims to appropriate copay assistance cards and foundation assistance, and apply assistance to adjudicated claims.
Troubleshoot complex insurance problems.
Assist with cross-functional activities involving different teams.
Answer patient calls as required and assist with patient needs and questions.
Triage and resolve voicemail, messenger, and inbox communications.
Obtain and coordinate payments.
Manage inbound faxes.
Participate in Quality Improvement/Assurance meetings, committees, and ongoing projects as needed.
Participate in pharmacy and organizational projects and initiatives.
Conduct patient outreach at the designated cadence in the care plan to assess medication adherence and identify deterrents.
Check for medication changes or discrepancies, including dose changes and discontinued medications.
Work within multiple computer systems simultaneously.
Document necessary call content with minimal wrap-up time.
Connect patients with a pharmacist regarding medication questions and ensure a prompt response.
Conduct data entry, data quality checks, and data reconciliation to ensure consistent documentation.
Perform other tasks as assigned by management.