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Job Description
- Accurately process claims for refill prescriptions including resolving rejected claims, assuring the patient responsibility is collected and documenting the shipment
- Review all pertinent medical documentation from physicians, and other health care facilities.
- Assist pharmacist in with the retrieval of prescription files, patient files and profiles and other such records pertaining to the practice of pharmacy including data entry and label preparation
- Initiate communication to a prescribing practitioner or their medical staff (or agent) regarding prescription refill authorization requests.
- Initiate communication to confirm the patient name, medication, strength, quantity, directions and date of last refill.
- Initiate communication to a prescribing practitioner or their medical staff (or agents) to obtain clarification on missing or illegible dates, prescriber name, brand/generic preference, quantity, DEA registration number or license number.
- Verify and transmit PBM claims and coordinate insurance benefits for new and/or recurring patients, process secondary claims, resolve rejected claims, and reverse paid claims if necessary.
- Maintains adherence to company policies and procedures, department requirements, safety standards and good housekeeping practices.
- Other duties as assigned or requested by management.
Job Requirements
- Must be graduated from the pharmacy college
- State registered pharmacy technician
- Strong communication skills and problem solving skills
- High school diploma or general education degree (GED)
- Computer Literate • Detail Oriented • Oral & Written Communication
- Ability to Multi-task
- Team Oriented individual