Job Description

Onsite opportunity in Berwyn PA with a growing organization

Opportunity for hybrid remote after 120 days

Hours - Mon to Fri 8:30am to 5pm, no weekends!

Three weeks of training provided

Start Date - May 27th

We are seeking a Pharmacy Technician, also called a Care Coordinator with a great organization in Berwyn PA. We are looking for someone passionate about helping people get the specialized therapies they need. This critical role serves as the first point of contact for patients. They will act as the patient advocate, their champion, guiding patients through the process of obtaining pharmaceuticals not available with chain pharmacies. This position will be required to be in the office 5 days a week, M-F, for the first 120 days.

Day to day:

Act as a patient advocate to gain insurance coverage for prescribed therapies.

Welcoming new patients and creating profiles with all the critical information.

Conduct periodic insurance verification and/or authorizations for patient coverage.

File claims for patient prescriptions and orders.

Complete collection activities per client program specifications.

Provide an initial and ongoing investigation and benefit explanation to the patient.

Obtain and maintain Prior Authorizations.

Create patient orders and associated prescription entries for new and refilled prescriptions.

Communicate with prescribers, including requesting new prescriptions.

Bill for RX drugs and administration supplies.

Assist patients with possible financial assistance.

Arrange all necessary documents and materials for initial and ongoing shipments.

Coordinate all deliveries and process any patient returns.

Obtain necessary consent forms for manufacturers or patient support organizations.

Assist pharmacists with day-to-day tasks such as filling prescriptions and entering prescription information into the patient management system for pharmacist verification.

Assist in preparing any ad hoc report request from clients

Necessary Skills, Education & Abilities:

2 or more years of experience with medical/pharmacy insurance verification including benefit investigation.

Knowledge of medical terminology required.

Knowledge of medical/pharmacy insurance benefit language- ie. EOBs, deductibles, out-of-pocket, co-insurance, co-pays, etc.

Ability to define CMS 1500s, provider numbers, CPT, HCPC’s, ICD9, NCPDP and NDC codes/numbers

Experience with prior authorization and SMN preparation.

Knowledge of insurance claim appeals.

Computer literate and proficient with Microsoft Office.

Ability to thrive in a fast-paced environment with constantly changing and competing priorities.

Excellent analytical skills and the ability to provide solutions to complex problems.

Ability to be highly transparent, ethical, and driven.

Relentless attention to detail, and the ability to be a creative self-starter and team player.

Excellent written and verbal communication skills, and interpersonal skills required.

Willingness to work a flexible schedule

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