![]() ![]() Pharmacy Technician Certification $26k-32k yearly est. Any previous experience in a call center preferred where performance was measured Any healthcare experience with a basic understanding of clinical terms and benefits investigation Any additional training in pharmacy/medical benefit access and requirements Demonstrated strength in listening, oral and written communications in EnglishĭESIRED PREVIOUS JOB EXPERIENCE/EDUCATION Excellent data management software skills with demonstrated adaptability to internal systems Demonstrated ability to manage a range of priorities and meet time commitments Excellent knowledge of insurance benefit investigation process and techniques Strong organization skills as well as attention to detail Superior telephone customer service skills ![]() 1 year of proven work experience in a healthcare or customer service industry Must be able to perform the essential job functions of this position with or without reasonable accommodation Perform other related duties as assigned Perform or assist with any operations, as required to maintain workflow and to meet business needs In a manner that provides the best available level of service and quality Ensure that work activities are conducted in compliance with regulatory requirements and the organization's defined standards and procedures, and Document case activity, communications and correspondence in computer system to ensure completeness and accuracy of patient contact records Complete a series of assessments mandated by either manufacturer contracts or operations and facilitates patient enrollment with manufacturer Hubs when required Prescription was received from alternate specialty pharmacy Coordinate verbal transfer by a pharmacist if specialty pharmacy has no record of prescription (in some jurisdictions) confirm with patient that Notify patients when their prescription has been transferred and follow up with specialty pharmacy to confirm the prescription was received (in some Track, report and escalate service issues arising from requests for authorizations, financial assistance or other issues that delay service Complete status check with insurance company regarding receipt/outcome of prior authorization and appeal obtain approval information andĪctivates copay cards based off of eligibility and specific drug prescribed Facilitate appeals process between the patient, physician and insurance company compose clinical appeals letters based off of specific denial reasonĪnd patient's clinical presentation and coordinate appointment of representative document Review for accuracy of prescribed treatment regimen prior to submission of authorization With customers to keep them continuously informed Obtain prior authorizations initiate requests, track progress, and expedite responses from insurance carriers and other payers, and maintain contact Investigate and verify benefits for pharmacy and medical third-party claims for assigned cases Communicate with patients to obtain information required to process prescriptions, refills, access benefits and apply charges against co-pay cards Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion, and safety. Working within the limits of standard or accepted practice. ![]() Perform duties to assist patients with access to benefits and co-pay cards, and schedule delivery of prescriptions provided through the specialty pharmacy, ![]()
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