Job Description
REQUIRED:
- Flexible between 8am- 6pm
- Full cycle of Prior Authorization- initial call intake, schedule first order of prescription delivery, LA Care health plan, insurance verification, set accounts and align benefits
- Registered Pharmacy Technician in California
PREFERENCE:
- Bilingual (English/ Spanish)
- Advanced in Excel
- Specialty Pharmacy
Comp: $18-$22/hr
POSITION SUMMARY:
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.
- Prior Authorization Pharmacy Technician will 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.
- Pharmacy Technician will 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. Review for accuracy of prescribed treatment regimen prior to submission of authorization.
- Facilitate appeals process between the patient, physician and insurance company by requesting denial information and facilitates obtaining the denial letter from the insurance, patient or physician. Composes clinical appeals letters based off of specific denial reason and patients clinical presentation. Ensures all clinical information and documentation are obtained prior to appeal submission. Coordinates appointment of representative document with patient and physician office.