Pharmacy Revenue Cycle Technician Specialist

Henry Ford Health; Detroit (MI); On-site; USD 42,000 - 58,000; Full time

Job summary

Henry Ford Health in Detroit, MI is seeking a Pharmacy Infusion Access Hub Technician to ensure patient access to infusion and injectable medications by managing insurance benefits, prior authorizations, and payer reviews.

You will coordinate with pharmacists, providers, patient access teams, and revenue cycle partners to support timely access, documentation, and reimbursement, while adhering to regulatory requirements and striving to improve workflow efficiency.

Qualifications

• Requires high school diploma or GED.
• Two years of inpatient pharmacy technician experience or two years of experience as a pharmacy technician.
• Two years of experience with automated dispensing systems preferred.
• Strong verbal and written communication skills; available for on-call support; highly analytical.
• Ability to work designated shifts, including weekends and holidays in a fast-paced environment.

Responsibilities

• Verifying insurance coverage and identifying prior authorization requirements with precision and attention to detail.
• Reviewing medication benefit information and supporting formulary and billing code accuracy.
• Gathering and organizing documentation from medical records to support claims and authorization processes.
• Monitoring authorization and claims status to ensure timely resolution.
• Managing appeals and processing denied claims in accordance with payer requirements.
• Resolving barriers that may delay patient care through systematic problem-solving and escalation procedures.
• Maintaining compliance with payer, institutional, and regulatory requirements.
• Identifying and implementing workflow improvement initiatives within the infusion access hub to enhance operational efficiency and accuracy.

Education

High school diploma or GED

MI Pharmacy Technician License

Tools

Automated dispensing systems

Job description

Job Description

The Pharmacy Infusion Access Hub Technician is responsible for ensuring patient access to infusion and injectable medications by managing insurance benefits, prior authorization requirements, payer formulary reviews, claims follow-up, and affordability barriers. This role coordinates with pharmacists, providers, care teams, insurance companies, patient access teams, and revenue cycle partners to ensure timely medication access, accurate documentation, and appropriate reimbursement.

Key responsibilities include:

• Verifying insurance coverage and identifying prior authorization requirements with precision and attention to detail
• Reviewing medication benefit information and supporting formulary and billing code accuracy
• Gathering and organizing documentation from medical records to support claims and authorization processes
• Monitoring authorization and claims status to ensure timely resolution and patient access
• Managing appeals and processing denied claims in accordance with payer requirements
• Resolving barriers that may delay patient care through systematic problem-solving and escalation procedures
• Maintaining compliance with payer, institutional, and regulatory requirements
• Identifying and implementing workflow improvement initiatives within the infusion access hub to enhance operational efficiency and accuracy

Education and Experience Required

• Requires high school diploma or G.E.D. equivalent.
• Requires at least two (2) years of experience as an inpatient pharmacy technician (for inpatient setting) OR two (2) years of experience as a pharmacy technician for all others.
• Two (2) years of experience with automated pharmacy dispensing systems preferred.
• PC skills as needed to perform job functions as assigned. Strong verbal/written skills; availability for on-call system support; highly analytical ability to solve complex technical problems.
• Ability to work designated shifts, including weekends and holidays. Ability to function in a fast-paced environment with established time constraints.
• Flexibility to deal with ever-changing health care environment. Ability to effectively manage multiple projects.

Certifications and Licensures Required

• Valid State of MI pharmacy technician licensure required.