Certified Pharmacy Technician, Insurance Verification

Perform duties to assist patients with access to benefits and co-pay cards, and schedule delivery of prescriptions provided through the specialty pharmacy, working within the limits of standard or accepted practice.

Essential Functions:• Communicate with patients to obtain information required to process prescriptions, refills, access benefits and apply charges against co-pay cards, and build trusted and enduring customer relationships that yield loyalty.

• Investigate and verify benefits for pharmacy and medical third party claims for assigned cases. May communicate with financial assistance team of drug manufacturers to apply for and secure financial assistance for patient when assigned.

• Obtain prior authorizations; initiate requests, follow up to provide additionally required information, track progress, and expedite responses from insurance carriers and other payers, and maintain contact with customers to keep them continuously informed.

• Track, report and escalate service issues arising from requests for authorizations, financial assistance or other issues that delay service, to ensure patient access and to avoid delays that may interrupt therapy.

• Schedule delivery of pharmaceuticals to suit patient needs and payer requirements.

• Communicate clinical inquiries to pharmacy or nursing team and arrange for direct patient communication or provide responses to patients, as appropriate. Identify opportunities for counseling by Registered Pharmacists or Nurse Counselors and make referrals as appropriate.

• Build and maintain effective business relationships with prescribers treating assigned set of disease states, and provide ongoing communication of specific case-related information as appropriate.