Position Summary
The Pharmacy Technician functions in multiple capacities, including prescription processing, fulfillment, shipping, patient support, prior authorization coordination, refill management, inventory control, insurance resolution, and adherence outreach while maintaining the highest standards of accuracy, quality, and customer service.
Essential Duties and Responsibilities
- Serve as a liaison between patients, pharmacists, providers, clinics, and other healthcare team members to facilitate medication, access and continuity of care.
- Contact patients to support medication adherence, refill compliance, and ongoing pharmacy care initiatives.
- Collaborate with providers to help patients overcome barriers to medication access and treatment.
- Answer incoming telephone calls and manage patient refill requests and pharmacy-related inquiries.
- Provide timely follow-up on refill requests, delayed prescriptions, undelivered shipments, and patient concerns.
- Research and obtain manufacturer co-pay assistance programs and co-pay cards when applicable.
- Maintain professional and compassionate interactions with patients while promoting adherence to prescribed therapies.
- Insurance, Prior Authorization & Administrative Support
- Verify and update patient demographic, insurance, and eligibility information.
- Manage incoming prior authorization requests and coordinate required documentation with providers and insurance companies.
- Contact insurance companies to verify patient coverage, benefits, and medication eligibility.
- Resolve insurance-related issues and adjudication concerns in accordance with organizational policies.
- Monitor co-pay reporting and ensure eligible claims are billed appropriately.
- Maintain continuous follow-up on outstanding refill authorizations and prescription renewals.
- Record all communications and activities involving patients, providers, clinics, physicians, staff, and insurance agencies.
Prescription Processing & Data Entry
- Enter and process new prescriptions into the pharmacy management system as permitted by state regulations and under the supervision of a pharmacist.
- Consult with pharmacists regarding prescription questions, clarifications, and processing concerns.
- Verify prescription information for completeness, accuracy, and compliance prior to processing.
- Efficiently process mailed, faxed, electronic, verbal, and written prescription orders.
- Route labels, rejections, billing exceptions, and processing issues appropriately.
- Perform rebills, balance billing, and claim corrections as necessary.
- Review patient medication profiles for additions, changes, duplications, and documentation requirements.
- Forward denials, errors, and exceptions to the appropriate pharmacist or department.
- Process medications for fulfillment and assist with workflow management to ensure timely prescription dispensing.
- Sort work queues and match refills for processing and shipment.
- Verify inventory selection by ensuring stock bottle information matches prescription labeling requirements.
- Fill prescribed medications using the correct National Drug Code (NDC) and quantity by utilizing automated counting equipment, including a Kirby counting device, and place medications into appropriately sized prescription containers.
- Verify patient labels, NDC numbers, medication quantities, and prescription information prior to pharmacist verification.
- Scan medication barcodes to confirm that prescription documentation, medication products, and patient records accurately correspond within the pharmacy system.
Shipping & Distribution
- Prepare and package pharmaceutical products to prevent damage and protect temperature-sensitive medications during transit.
- Review patient delivery preferences and shipping instructions to ensure accurate order fulfillment.
- Select and coordinate appropriate shipping methods based on patient requirements and organizational procedures.
- Monitor shipments and assist with resolution of delayed, lost, or undelivered prescription orders.
Inventory Management
- Assist with full inventory counts and routine cycle counts to ensure accurate inventory control.
- Identify, document, and remove expired or outdated medications for return to manufacturers or disposal according to policy.
- Maintain organized inventory and support medication replenishment activities.
- Verify proper storage and handling of medications in accordance with manufacturer and regulatory requirements.
Quality Assurance & Compliance
- Adhere to all federal, state, accreditation, and organizational pharmacy regulations and standards.
- Maintain knowledge of prescription medications, including brand and generic equivalents.
- Understand insurance limitations, fee schedules, reimbursement processes, and adjudication requirements.
- Ensure all patient interactions, prescription activities, and pharmacy processes are accurately documented.
- Protect patient confidentiality and comply with HIPAA and organizational privacy standards.
- Perform additional duties as assigned by pharmacy leadership.
Required Qualifications
- High school diploma or GED required.
- Must be licensed (unrestricted) and registered as a Pharmacy Technician or be willing to apply for a temporary registration as a Pharmacy Technician Trainee in the state of employment.
- Effective verbal and written communication skills in both English and Spanish, required.
- Experience in retail, specialty, mail-order, or ambulatory pharmacy preferred.
- Knowledge of prescription processing, insurance billing, medication fulfillment, and pharmacy operations.
- Experience working with prior authorizations and third-party insurance plans preferred.
- Proficiency with pharmacy software systems and electronic health records.
- Strong customer service, communication, organizational, and problem-solving skills.
- Ability to manage multiple priorities in a fast-paced environment.
Core Competencies
- Medication Access & Insurance Resolution