The Pharmacy Technician Specialist reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines, and all other regulatory and accreditation standards.
Under the direction of a registered pharmacist, performs all technical duties associated with the daily operation of the dispensing areas; performs prescription-related, unit dose-related, and sterile product-related functions; performs manufacturing procedures that have been documented in the Department records.
Responsibilities:
- Coordinates and effectively communicates with management, co-workers, customers, and other healthcare professionals regarding changes to workflows, updates, backorder, and new drug information when/where appropriate
- Responsible for providing access to medications for patients by completing Prior Authorization Requests, co-pay assistance programs, medication assistance programs, and benefits investigation
- Coordinates with third-party insurance, clinical staff, and patients to effectively process prior authorization requests for medications within the prescribed timelines
- Directly enrolls eligible patients into manufacturer patient assistance co-pay programs
- Identify, research, and resolve issues and consumer complaints
- Check incoming prescriptions for completeness of all required information needed for processing
- Possess working knowledge of participating third-party payors and their requirements
- Establish and maintain open communication with pharmacy operations analysts regarding third-party billing issues and centralized procurement team regarding ordering and inventory matters
- Assists with prescription audits as needed
- Educate pharmacy staff regarding third-party billing policies and procedures as needed
- Answers and triages patient, provider, and third-party calls to appropriate individuals adhering to phone scripts in a courteous and professional manner
- Contact payers for lost medication, replacement, or vacation overrides
- Troubleshoot and resolve billing rejections and subsequently rebill claims to appropriate carriers for all commercial, federal, and state insurance plans
- Verify and accurately update patient demographic information in appropriate system(s)
- Document patient’s insurance information in appropriate system(s)
- Refer and document any clinical questions regarding prescriptions, drug information, or health conditions requiring follow-up to a pharmacist
- Spend ≤ 5% of time on quality management of the program
- Performs the duties and responsibilities of a Pharmacy Technician at advanced level.
- Leads performance improvement initiatives
- Liaison between pharmacy and other departments
- Assists with/coordinates pharmacy technician schedule, services, prioritizing assignments and workflow, and promoting situational decision making/problem solving
- Fosters a team environment by providing education and training
- Maintains documentation of completion for media fill and fingertip testing
- Participates in site meetings (i.e. Drug Shortage, huddles, staff meetings)
- Responsible for controlled substance receiving, reconciliation, discrepancy tracking, and investigations
- Performs minor repairs of ADS machines
- Participates in projects as assigned by manager
- Handles recalls, crash carts monitoring, and kitcheck ordering
- Troubleshooting
- Restocks
- Performs Tech-Check-Tech (i.e. automated dispensing cabinet (ADC) runs/controlled substance in ADC; barcode scanned pills, pre-mixed IV bags)
- Other duties as assigned