Pharmacy Tech- Specialty Pharmacy Rep- King of Prussia

Thomas Jefferson University • Montgomery County, PA

5d • Onsite

About The Position

The Specialty Pharmacy Representative I drives refill queues and assists patients, physicians, and pharmacists with claim adjudication and review, benefit investigations, financial assistance applications, refill and adherence activities, and other programs supporting optimal patient outcomes. The role includes entering patient details—including name, date of birth, insurance information, allergies, and medication history—into therapy-specific patient assessment software. Under the direction of a patient care pharmacist, the representative also assists with prescription filling and distribution in accordance with applicable law.

Based at Jefferson Specialty Pharmacy in King of Prussia, Pennsylvania, this role coordinates medication refills and deliveries, evaluates claim responses and patient needs, identifies issues that may require escalation, and helps patients understand insurance coverage and financial assistance options. The representative works with patients, physicians, payors, pharmacists, and clinical staff and contributes to departmental quality assurance and improvement activities.

Requirements

• At least 3 years of experience in a customer service role.
• At least 1 year of experience in a specialty pharmacy, hospital, health insurance company, benefits department, or another related healthcare environment.
• Proficiency with computers and Microsoft applications.
• Typing speed of 35 words per minute.
• Critical-thinking skills to solve problems and make informed decisions, with the ability to learn from past experiences.
• Ability to communicate professionally and efficiently in writing and verbally with patients, physicians, payors, and clinical staff, in person and by phone.
• Flexibility to adapt to changing departmental needs, including assisting teammates and adjusting assignments.
• Strong attention to detail and organization, and the ability to learn quickly.
• Ability to adapt to a dynamic work environment.
• Demonstrated ability to handle difficult conversations professionally and with care.

Nice To Haves

• High school diploma or GED equivalent preferred.
• Associate’s or bachelor’s degree preferred.
• Certified Pharmacy Technician (CPhT) preferred.
• Experience with clinical software systems, specialty medications, and Medicare billing is highly preferred.

Responsibilities

• Adjudicate and review claims responses for reimbursement and profitability.
• Analyze claim messages and determine next steps for escalating orders, including prior authorization, benefits investigations, step therapy, non-formulary issues, and financial assistance.
• Schedule delivery of specialty, high-cost, and maintenance medications to support patient adherence and compliance with prescribed therapy and departmental guidelines.
• Assess whether patients need clinical intervention based on refill responses or other information they provide.
• Identify barriers to care, non-compliance, and changes in therapy or dosing, and escalate these concerns to the clinical support team when appropriate.
• Review patient charts to ensure information is accurate and up to date.
• Explain insurance coverage and copay responsibility to patients, including available financial resources.
• Screen patients for financial assistance and submit applications on their behalf when applicable.
• Print paperwork and fill prescriptions under the supervision of a clinical pharmacist.
• Track and monitor deliveries, ensuring medication arrives undamaged, and arrange reshipment when necessary.
• Contribute to departmental Quality Assurance/Quality Improvement activities, with expected participation of at least 2% of time and additional participation as needed.
• Interact with coworkers, visitors, and other staff consistent with Jefferson’s iSCORE values.

Benefits

• Medical insurance, including prescription coverage
• Supplemental insurance
• Dental insurance
• Vision insurance
• Life and AD&D insurance
• Short- and long-term disability insurance
• Flexible spending accounts
• Retirement plans
• Tuition assistance
• Voluntary benefits, including access to group insurance rates and discounts
• Tuition discounts at Thomas Jefferson University after one year of full-time service or two years of part-time service
• Medical insurance, including prescription coverage, is available to all colleagues, including those working less than part-time

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED