Pharmacy Technician - Specialty Pharmacy

Optime Care•Earth City, MO

15h•Hybrid

About The Position

Optime Care is seeking a Pharmacy Technician, or Care Coordinator, as we call them internally, for our Earth City, MO location. We are looking for someone passionate about helping people get the specialized therapies they need. This critical role serves as a patient's first or ongoing point of contact. They will act as the patient advocate and champion, guiding patients through obtaining pharmaceuticals unavailable at chain pharmacies. This position will be required to be in the office for the first 120 days for training purposes. It can then be a hybrid role depending on business needs.

Requirements

A high school diploma or equivalent is required.
2 or more years of experience with medical/pharmacy insurance verification, including benefit investigation.
Current Missouri BOP Pharmacy Technician license, or Nurse license in good standing.
Knowledge of medical terminology required.
Knowledge of medical/pharmacy insurance benefit language- ie. EOBs, deductibles, out-of-pocket, co-insurance, co-pays, etc.
Ability to define CMS 1500s, provider numbers, CPT, HCPC’s, ICD9, NCPDP and NDC codes/numbers
Knowledge of Medicare and Medicaid billing.
Relentless attention to detail, and the ability to be a creative self-starter and team player.
Computer literate and proficient with Microsoft Office.
Ability to participate in and facilitate group meetings.
Ability to thrive in a fast-paced environment with constantly changing and competing priorities.
Excellent analytical skills and the ability to provide solutions to complex problems.
Ability to be highly transparent, ethical, and driven.
Excellent written and verbal communication skills and interpersonal skills are required.
Willingness to work a flexible schedule.

Nice To Haves

Patient Assistance Program knowledge is a plus.
Experience with prior authorization and SMN preparation.
Knowledge of insurance claim appeals.

Responsibilities

Act as a patient advocate to gain insurance coverage for prescribed therapies.
Welcome new patients and create profiles with all the critical information.
Conduct periodic insurance verification and/or authorizations for patient coverage.
File claims for patient prescriptions and orders.
Complete collection activities per client program specifications.
Provide an initial and ongoing investigation and benefit explanation to the patient.
Obtain and maintain Prior Authorizations.
Create patient orders and associated prescription entries for new and refilled prescriptions.
Communicate with prescribers, including requesting new prescriptions.
Bill appropriate entities for RX drugs and administration supplies.
Assist patients with possible financial assistance.
Arrange all necessary documents and materials for initial and ongoing shipments.
Coordinate all deliveries and process any patient returns.
Obtain necessary consent forms for manufacturers or patient support organizations.
Assist pharmacists with day-to-day tasks such as filling prescriptions and entering prescription information into the patient management system for pharmacist verification.
Assist in preparing any ad hoc report requests from clients.
Perform other related duties as assigned or as necessary; remains flexible and adaptable in work schedules and work assignments as defined by departmental and organization needs.