Prior Authorization Pharmacy Technician
About The Position
Cardinal Health Innovative Delivery Solutions With over 45 years of experience in helping hundreds of hospital and outpatient pharmacies, we provide access to best practice strategies and tactics to control costs, improve workflow and enhance safety. Cardinal Health Innovative Delivery Solutions is one of the largest employers of acute-care pharmacist in the United States. This position is located at Adams Memorial Hospital Monday-Friday 9:00am-5:30pm Schedule: Full-time 40 hours/week The Pharmacy Technician & Prior Authorization Coordinator is responsible for completing necessary functions to ensure medication coverage as part of an outpatient provider’s office and to provide consistent, excellent patient care. Duties and responsibilities include performing tasks related to the management of third-party billing, insurance verification, prior authorizations, and financial support. Other responsibilities include supporting multiple facets of the pharmacy such as accuracy and proficiency in data entering, coordination of medication refills via telephone, filling of medications, ordering, appropriate packaging and shipments of medications, and delivering exceptional customer service.
Requirements
- Previous customer service experience required
- Current licensure as a Pharmacy Technician in the state of Indiana
- High School diploma or equivalent preferred
- Experience conducting and documenting patient health insurance benefit investigations, prior authorizations, and appeals is preferred
- Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies is preferred
- Critical and creative thinking is a must
- Knowledge of 340B is preferred
- Important to have a strong attention to detail and be able to work independently
- May require vendor credentialling
Responsibilities
- Submit prior authorizations and appeals for brand name, high cost drugs in partnership with Outpatient Clinic staff.
- Establish and maintain good working relationships with Outpatient Clinic staff to maintain effective communication regarding third-party billing issues.
- Review and screen patients to determine if the patient has adequate prescription coverage.
- Be a resource in a provider’s office to answer questions around insurance coverage and copays.
- Function as primary third-party billing resource for office and pharmacy staff.
- Troubleshoot and resolve billing rejections and subsequently rebill claims to appropriate carrier for all commercial, federal, and state insurance plans.
- Identify patients who may qualify for patient medication assistance programs, grants or copay assistance.
- Assist with prescription audits.
- Assist in the development, implementation, and evaluation of third-party billing policies and procedures.
- Educate office and pharmacy staff about third-party billing policies and procedures as needed.
- Gather and document demographics, insurance information, needs assessment, and other data.
- Communicate the anticipated self-pay portion (co-payments/deductibles/co-insurance) with patients and establish payment arrangements based on the Financial Policy and document the financial resolution in the registration/billing systems.
- Assist in enrollment of patients in manufacturer copay cards.
- Participate in ordering medications and pharmacy supplies, as needed.
- Assist in filling medications, as needed.
- Participate in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth.
- Participate in performance and quality improvement activities as assigned by Director of Outpatient Pharmacy.
- Assist in oversight of compliance of the 340B Drug Discount Program.
- Ensure appropriate storage of all medications and assist patients with accurate delivery of medication via courier, pharmacy pick-up, or mail
Benefits
- Cardinal Health offers a wide variety of benefits and programs to support health and well-being.
- Medical, dental and vision coverage
- Paid time off plan
- Health savings account (HSA)
- 401k savings plan
- Access to wages before pay day with myFlexPay
- Flexible spending accounts (FSAs)
- Short- and long-term disability coverage
- Work-Life resources
- Paid parental leave
- Healthy lifestyle programs
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
