Position Summary
The Licensed Pharmacy Technician is responsible for entering prescription information, processing prescription requests (new and/or refill) while upholding quality and performance standards, researching rejected claims, making outbound calls to patients, insurance, or prescribers (if applicable).
Essential Duties/Responsibilities
- Interpret prescription orders and enter data accurately and timely.
- Place outgoing phone calls to patients, doctors and insurance companies to obtain clarification on prescription orders (if applicable).
- Utilizes reasoning skills to identify missing information and make processing determinations based upon policy and client guidelines.
- Works under general supervision relying on instructions, work process guidelines, policy and procedures, and company knowledge/experience to perform the function(s) of the job.
- Contact patients to follow up on an incident or provide a resolution (if applicable).
- Research claims that have been rejected by the insurance and resolve the specified rejection.
- Perform other duties as assigned.
Required Skills/Abilities
- Strong interpersonal and customer service skills.
- Ability to maintain confidentiality of information and data in accordance with policies.
- Ability to exercise considerable judgment, maintain confidentiality, and act in a diplomatic manner.
- Ability to independently identify, research and resolve issues.
- A decisive individual who possesses a detail-oriented perspective.
- Sound technical skills, analytical ability, good judgment, and strong operational focus.
- Ability to work with peers in a team effort.
- Demonstrated ability to manage multiple priorities and deadlines.
- A well-organized and self-directed individual who is able to work with minimal amount of supervision.
- Capability to efficiently complete tasks in a fast-paced environment.
- Ability to lift heavy objects up to 15 pounds.
- Ability to work extended hours, weekends, and holidays in alignment with departmental and industry demands.
Education/Experience
- High School Diploma or GED.
- Registered Pharmacy Technician licensed and in good standing with applicable home State Board of Pharmacy and Michigan Board of Pharmacy.
- Certified Pharmacy Technician (CPhT), licensed through the Pharmacy Technician Certification Board (PTCB).
- Experience or knowledge of claims adjudication preferred.
- Experience or knowledge of secondary billing practices including prescription discount cards and Medicaid.
- Proficient in Microsoft Office and industry related software programs
Preferred Skill/Abilities
- Prior experience in Retail, Mail Order of Specialty Pharmacy, PBM, pharmaceutical or managed health care industry preferred.
Work Environment/Physical Requirements
- Hybrid home/office environment, with minimal exposure to excessive noise or adverse environmental issues, and occasional local and/or overnight travel, including exposure to heat, cold, and inclement weather conditions. Transportation for travel typically will include automobile and plane.
- Ability to sit and stand for prolonged periods of time.