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Pharmacy Technician

APN Software Services Inc Costa Mesa, CA

  • Expired: over a month ago. Applications are no longer accepted.
Job Description

Key Qualifications/Must-haves (please any information that's not included in the provided job description):

High School Diploma or GED

Current National Pharmacy Technician Certification

3 years' experience as a Pharmacy Technician

Minimum 1-year experience working with Prior Authorizations

Specific Education Requirements: CPHT required, PTCB preferred but not required.

JOB SUMMARY:

The Pharmacy Technician of the refill clinic reports directly to the Pharmacy Technician Lead, is responsible to assist and process all incoming pharmacy referrals, refills, emails, chat messages and faxes related to prescription refill requests, in a team-based, high volume medical group setting. In addition, the Pharmacy Technician will also be responsible for processing prior authorization requests on both Medical and Pharmacy benefits. The Pharmacy Technician will assist in checking eligibility, coordinating pharmacy benefits, preventing any potential refill delay and follow-up for all requests, to assure they are completed in a timely manner.

JOB SPECIFIC ESSENTIAL FUNCTIONS:

Manage incoming requests from call center, provider and referral team for new medications and medication refills.

Responsible for processing medication prior authorizations and script renewals for patient.

Ensure scripts are filled in a timely manner by coordinating with the requesting provider, following up with the Pharmacy Benefit Manager (PBM) as appropriate, and reaching out to the necessary department as needed.

Ensures the patient completed the necessary labs and diagnostic testing as required prior to dispensing certain medication.

Responsible for understanding the clinical protocols for medication refills as established by the organization

Ensure that the patient has attended any required provider visits and follows all authorized medication protocols.

Understands the insurance and healthcare benefits, submits prior authorizations to the UM department or to the PBM, and ensures that the required supporting documentation is submitted for review.

Adheres to the implemented refill center workflow.

Adapts easily to a high volume, fast pace medical group setting.

Manage escalated patient care issues in collaboration with the member services, providers and Case Management teams as appropriate.

Reports immediately to the Pharmacy Technician Lead on adverse concerns or workflow issues related to quality of care or patient care oversights.

Assist the quality team in any HEDIS or Quality Star measure initiatives and protocols as appropriate for medication adherence and refill measures.

Other duties as assigned.

EDUCATION, TRAINING & EXPERIENCE:

Required:

High School Diploma or GED

Current National Pharmacy Technician Certification

3 years' experience as a Pharmacy Technician

Minimum 1-year experience working with Prior Authorizations

Preferred:

3 years' experience in third party prescription program claims adjudication

2-3 years' experience working with prior authorizations

Experience working in a high volume and fast paced pharmacy environment

Insurance benefit knowledge and understanding

EPIC or other EMR use or knowledge

SKILLS OR OTHER QUALIFICATIONS:

Required:

Demonstrate a working knowledge of popular brand and generic names

Knowledge of drug classifications

Prior Authorization experience

Knowledge of common medical terminology

Understanding of national drug code

Understanding Clinical Protocols and Standards of Care for Medication Management Therapy

Strong computer skills including MS Word and MS Excel

Possess good communication skills and ability to work independently and in a team setting

Maintains a positive attitude in changing conditions

Detail oriented, personable, and efficient in all tasks and communication

Efficient in workflow, always working on a task/project

Well maintained organizational and prioritization skills

Performs all job duties with a professional appearance and attitude at all times

Ability to work in a fast-paced, high volume environment

Proficient in computer and Microsoft Office Software skills especially Excel


APN Software Services Inc

Address

Costa Mesa, CA
92626 USA
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