Riverside Health System
Specialty Pharmacy Technician - Prior Authorizations
Riverside Health System, Newport News, Virginia, United States, 23600
Newport News, Virginia
Riverside Regional Medical Center in Newport News, Virginia is currently seeking a labor pool (as needed) Speciality Pharmacy Tech - Prior Authorizations.
Licenses and Certifications
Licensed Pharmacy Technician with the Virginia Department of Health Professions (VDHP) Upon Hire (Required) and PTCB or ExCPT certified (Required) orLicensed Practical Nurse (LPN) - Virginia Department of Health Professions (VDHP) Upon Hire (Required) orCertified 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)Education
Program Graduate, Pharmacy Technician Training Program or equivalent (Required) orProgram Graduate, Licensed Practical Nurse (Required) orProgram 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)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.Skills and Abilities
Familiar with medical and pharmacy terminologyPrescription drug and over-the-counter knowledgeBasic math skills, including pharmaceutical calculationsBasic pharmacy workflowUnderstanding pharmacy computer systemsAbility to navigate and read electronic health recordStrong written and verbal communication skillsAbility to prioritize, problem solve and multitaskExcellent customer service skillsKnowledge of patient assistance programsExperience with prior authorization of medicationsStrong organizational skills and detail oriented
To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers.
Riverside Regional Medical Center in Newport News, Virginia is currently seeking a labor pool (as needed) Speciality Pharmacy Tech - Prior Authorizations.
Licenses and Certifications
Licensed Pharmacy Technician with the Virginia Department of Health Professions (VDHP) Upon Hire (Required) and PTCB or ExCPT certified (Required) orLicensed Practical Nurse (LPN) - Virginia Department of Health Professions (VDHP) Upon Hire (Required) orCertified 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)Education
Program Graduate, Pharmacy Technician Training Program or equivalent (Required) orProgram Graduate, Licensed Practical Nurse (Required) orProgram 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)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.Skills and Abilities
Familiar with medical and pharmacy terminologyPrescription drug and over-the-counter knowledgeBasic math skills, including pharmaceutical calculationsBasic pharmacy workflowUnderstanding pharmacy computer systemsAbility to navigate and read electronic health recordStrong written and verbal communication skillsAbility to prioritize, problem solve and multitaskExcellent customer service skillsKnowledge of patient assistance programsExperience with prior authorization of medicationsStrong organizational skills and detail oriented
To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers.