Pharmacy Technician Specialty

101 Riverside Hospital, Inc.; Chesapeake (VA); On-site; USD 32,000 - 44,000; Full time

Job summary

Riverside Health System in Chesapeake, Virginia is seeking a Specialty Medication Coordinator to manage third-party billing and patient financial assistance for high-dollar specialty meds. You will handle referrals, prior authorizations, and patient documentation to support timely cancer and other specialty therapies.

Ideal candidates have Pharmacy Technician background with LPN or CMA credentials and experience with patient assistance programs, HIPAA compliance, and EHR systems.

Qualifications

• Education: Pharmacy Technician Training Program or equivalent.
• Experience: 3-4 years as Pharmacy Technician, LPN or CMA.
• 1 year experience obtaining and managing prior authorizations.
• 1 year experience with patient assistance programs.

Responsibilities

• Process referrals and submit clinical docs to carriers/manufacturers to expedite prior auth.
• Collaborate with departments to obtain prior authorizations and patient assistance.
• Assist with medical necessity documentation to expedite approvals.

Skills

Medical terminology

Pharmacy terminology

Customer service

HIPAA compliance

EHR navigation

Education

Pharmacy Technician Training Program

Licensed Practical Nurse

Certified Medical Assistant

VDHP Pharmacy Technician license

Job description

Chesapeake, Virginia Hiring Range $23.90 - $31.10/Hourly

Actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs.

Overview

A Specialty Medication Coordinator is responsible for performing tasks related to the management of third-party billing or patient financial assistance for patients within the health system. A Specialty Medication Coordinator assists with managing and processing high dollar specialty medications (e.g. oncology, infectious disease, multiple sclerosis) and may be responsible for benefits investigation, obtaining prior authorizations, copay/foundation assistance, drug replacement services, and patient financial counseling. Additional activities may include patient onboarding, order entry, financial tracking, patient care coordination, medication ordering/tracking, cold chain distribution and shipping activities.

What you will do

• Timely process of referrals and submit clinical supporting documentation to insurance carriers, manufacturers, or foundations to expedite prior authorization and/or patient assistance processes.
• Collaborate with other departments to assist in obtaining prior authorizations, patient assistance medications or financial assistance.
• Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.
• Follows prior authorization and/or patient assistance workflows and policies/procedures.
• Demonstrates the ability to work independently, meet deadlines and possesses excellent time management skills.
• Perform tasks accurately and efficiently.
• Possesses excellent interpersonal, customer service and communication skills (both written and verbal); timely responses to key stakeholders.
• Accurate documentation of all intake referrals and/or prior authorization information in patient medical record or patient assistance tracking software in compliance with policy and procedure/workflow.
• Completes timely documentation within the required tracking systems and retrieves necessary documentation and maintains up to date knowledge of the pharmaceutical companies’ patient assistance programs.
• Proactively tracks and manages patient refills/outreach to ensure timely prescription/infusion service.
• Proactively works on prior authorization and patient assistance enrollments that are due to expire.
• Secure patients’ demographic and medical information in compliance with organization HIPAA policies and procedures.
• Assists management with inspections, audits, reports and training to ensure compliance with standards and to provide quality service.

Qualifications

• Education Program Graduate, Pharmacy Technician Training Program or equivalent (Preferred) or Program Graduate, Licensed Practical Nurse (Required) or Program Graduate, Certified Medical Assistant (Required)
• Experience 3-4 years Experience as a Pharmacy Technician, LPN or CMA (in lieu of education) (Required)
• 1 year Experience obtaining and managing medication prior authorization as part of job function (Preferred)
• 1 year Prior Experience obtaining and managing patient assistance program applications (Preferred)

Skills and Abilities

• Familiar with medical and pharmacy terminology.
• Prescription drug and over-the-counter knowledge.
• Basic math skills, including pharmaceutical calculations.
• Basic pharmacy workflow.
• Understanding pharmacy computer systems.
• Ability to navigate and read electronic health record.
• Strong written and verbal communication skills.
• Ability to prioritize, problem solve and multitask.
• Excellent customer service skills.
• Knowledge of patient assistance programs.
• Experience with prior authorization of medications.
• Strong organizational skills and detail oriented.

Licenses and Certifications

• Registered Pharmacy Technician - Virginia Department of Health Professions (VDHP) Upon Hire(Required) and Pharmacy Technician Certification Board (PTCB) - Pharmacy Technician Certification Board (PTCB) PTCB or ExCPT Upon Hire(Required)
• Licensed Practical Nurse (LPN) - Virginia Department of Health Professions (VDHP) Upon Hire(Required)
• Certified Medical Assistant (CMA) - American Association of Medical Assistants (AAMA) Upon Hire(Required)
• Advanced certification in specialty pharmacy field (PTCB, ASHP, NCODA and other approved programs) (Preferred)

About Riverside Health System

To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers. If loving your work is important to you, consider a career at Riverside. By joining our team, you can make a difference in people's lives. Our mission is to care for others as we would care for those we love. We extend that sense of caring to every patient, resident and customer, as well as to each member of our team. We offer care at all stages of life, in hundreds of locations, giving you room to grow your career, along with great benefits and perks. At Riverside Health, your trust and safety are our top priorities.