Primary Duties and Responsibilities:

• Under the supervision of the pharmacist, assists in pharmacy practice in accordance with state, federal, and Company policy.

• Operates pharmacy systems and software to obtain patient and drug information, process prescriptions, and perform other necessary functions on the system per policies and regulations.

• Reviews and researches invalid prescriptions to determine needed information.

• Contacts the provider or patient to obtain accurate information to continue processing the prescription.

• Triage and resolve issues or concerns relating to invalid prescriptions, inability to take medications, and issues to the appropriate team (i.e., PA, appeals, funding, COB, clinical).

• Contacts insurance or payer to verify that prescribed medication coverage is within defined perimeters.

• Works with the pharmacist and/or nurse to contact providers and insurance companies to verify prescriptions, overrides, and other approvals.

• Enters patient, doctor, insurance, and prescription information quickly and accurately into the computer system and processes the claims for adjudication to determine coverage issues.

• Investigates patient insurance benefits and other supplemental payer information to minimize out-of-pocket expenses; advocate on the patient’s behalf to identify and assess reimbursement coverage options for those with insurance.

• Process prescriptions from intake to order completion.

• Maintains knowledge of Company loss prevention techniques.

• Completes assignments and works on special projects as assigned.

• Stays current with industry practices that relate to job responsibilities and integrates them.

• Immediately reports prescription errors to the pharmacist on duty and adheres to Company policies and procedures.

• Handles telephone calls that do not require the personal attention of the pharmacist.

• Processes manual claims for third-party program prescription services and performs other clerical duties as assigned by the Pharmacy Manager.

• Builds rapport with coworkers, internal customers, and other departments to promote the highest customer service and a positive company image.

• Follows drug manufacturer REMS program requirements for limited distribution of drugs.

• Adheres to all company policies as indicated in the handbook and directives issued by management. Has reviewed the Policy and Procedure manual.

Additional Fulfillment Requirements:

• Responsibilities will include document routing of new referrals, refill prescriptions, and new prescriptions on existing patients via the portal, e-mails, fax, etc.

• Assists with obtaining refills on expired prescriptions as needed.

• Use workflow software to record incoming and outbound contact attempts with patients, doctors, and insurance companies.

• Records the receipt of prescriptions, chart notes, and insurance information.

• Documents dates and times received and any applicable authorization or pharmacy referral information. Appropriately attaches documents to the electronic health record of the patient.

• Works closely with Fulfillment Pharmacist to provide a team approach to assisting existing patients with their new or refill prescription needs.

• Prints packing slip, customer receipt, and prescription label after review.

• Perform duties such as ordering, unpacking, checking, and storing shipments of pharmaceuticals and supplies, processing claims for shortages/overages and damages in shipments, and returning outdated and overstocked merchandise.

• Pulls medications, counts, and fills prescriptions. Compounds non-sterile prescriptions accurately.

• Corrects lot numbers in the computer system to reflect drug dispensed (as required), and logs lot numbers in perpetual inventory books for designated medications.

• Maintains pharmacy temperature and humidity logs in the pharmacy area.

• Assists with inventory counts as needed.

• Assists customers with picking up medications.

• Cleans counters and equipment and performs trash removal duties as needed. Utilizes pharmacy workflow software to electronically track prescriptions.

• Monitors pharmacy for adequate stock of medications and supplies.

• Performs shipping duties as needed.

• This is an office-based position.

Professional Competencies:

• Proficient with MS Excel, Word, and Outlook

• Understanding of insurance verification and online prescription adjudication Strong oral, written, and interpersonal skills

• Self-initiative

• Demonstrated ability to meet tight deadlines

• Ability to work with all levels of internal management and staff, as well as outside clients and vendors

Educational and Experience Requirements:

• High school diploma or equivalent

Licensure and Certification Requirements:

• Current unrestricted state pharmacy technician registration/licensure

• National or state pharmacy technician certification per applicable State Board of Pharmacy requirements

Physical Requirements:

• In an 8-hour day, the employee may be asked to lift/carry 35 lbs.

• In an 8-hour day, the employee may stand/walk for approximately 7 hours.

• The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc., and traverse conferences, meetings, and remote events.

• Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer.

• The ability to communicate information and ideas so others will understand. Must be able to exchange accurate information in these situations.

• The ability to observe details at close range (within a few feet of the observer).

Working Conditions:

Fulfillment Pharmacy Operations; working in the pharmacy

Equipment Used to Perform the Job:

Computers, keyboards, mouse, monitors, fax, and/or headsets for phone work. Software specific to the position, including but not limited to Microsoft Outlook and Skype. Must lift and traverse the area to move paper and supplies to use the equipment.

Contacts: 

Frequently interact with coworkers, intradepartmental staff of the Company, managers, leaders, Vendors, and customers. High interactions with physicians and the medical community to support the sales and perfection of the referral to fill.

Confidentiality:

The position Interactions with medical personnel and patients and accesses proprietary and medical (HIPAA) information in various interactions and matters.