Marsh & McLennan Companies has flagged the Personal Lines Service: Call Center Representative II job as unavailable. Let’s keep looking.

Overview

Specialty Pharmacy Technician Call Center

Monday-Friday 8AM-5PM

Full Time Benefits

Eligible for $3,000 sign on, if external

Receives and processes prescription referrals received by the Specialty Pharmacy including data entry, insurance processing, and prior authorization completion for specialty medications. Understands pharmacy benefit and medical benefit claims submission process for reimbursement of prescription medications. Communicates with patients/caregivers, insurance company representatives, and other members of the healthcare team for patients to initiate and continue therapy

Responsibilities

Daily work assignments

  • Looks at the individual needs of each patient/customer and matches those needs to the many services UnityPoint at Home has to offer; utilizes other members of the home care coordination team as necessary to coordinate services outside of the specialized service line.
  • Processes all incoming prescription orders; obtains demographic, financial, and other qualifying data to verify benefits and obtain authorization for specialty medications.
  • Processes test claims of health system’s specialty pharmacy prescriptions through pharmacy dispensing software to determine available pharmacy options through patient insurance plans. Communicates/coordinates with patients/caregivers and members of the healthcare team appropriate actions based on patients’ benefits.
  • Specializes in specialty pharmacy service line yet is responsible for having a basic knowledge of all service lines.
  • Initiates and coordinates prior authorization requests to third party payers and maintains a working knowledge of third-party payer guidelines. Follows up with third party payers as necessary.
  • Collects insurance information, runs test claims, obtains medical records as required for completion of prior authorizations.
  • Re-verifies eligibility and benefits when patient starts a new benefit year.
  • Provides customer service to patients and physicians’ offices and coordinates the delivery of medications with patients/caregivers and/or members of the healthcare team via inbound and outbound calls, email, and other electronic messaging.
  • Operates pharmacy dispensing software and health system electronic health record to record, document, and retrieve pertinent medical information within the patients’ electronic medical record to ensure appropriate agency services are provided in a timely manner.
  • Establishes and maintains positive working relationships with current and potential providers and referral sources.
  • Upholds expectations and perceptions of UPAH as a high-quality provider of services by maintaining excellent customer service.
  • Maintains a working knowledge of relevant regulations affecting patients and the operation of our business.
  • Performs patient follow up phone calls as directed by manager or supervisor.
  • On-call duties may be required on a rotation basis, including weekends and holidays.
  • Prohibited from conducting evaluations or interpreting any clinical decision. Refers clinical questions to appropriate staff.

Qualifications

Education:

  • High school diploma or equivalent

Experience:

  • One year of medical experience; preferably in community home health or pharmacy

License(s)/Certification(s):

  • Nationally certified pharmacy technician registered with the Iowa Board of Pharmacy as a Certified Pharmacy Technician (or registered as technician trainee if not yet certified)
  • Registered Pharmacy Support
  • Valid driver’s license when driving any vehicle for work-related reasons

Knowledge/Skills/Abilities:

  • Strong interpersonal skills
  • Strong problem-solving skills with previous customer service experience
  • Basic knowledge of computer applications (i.e. Word, Excel) and operations

Other:

Use of usual and customary equipment used to perform essential functions of the position.

Why UnityPoint Health?

  • Commitment to our Team – For the second consecutive year, we're proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare for our commitment to our team members.
  • Culture – At UnityPoint Health, you matter. Come for a fulfilling career and experience a culture guided by uncompromising values and unwavering belief in doing what's right for the people we serve.
  • Benefits – Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in.
  • Diversity, Equity and Inclusion Commitment – We’re committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation.
  • Development – We believe equipping you with support and development opportunities is an essential part of delivering a remarkable employment experience.
  • Community Involvement – Be an essential part of our core purpose—to improve the health of the people and communities we serve.

Visit https://dayinthelife.unitypoint.org/ to hear more from our team members about why UnityPoint Health is a great place to work.

#UPaHomeNursing

Read Full Description
Confirmed 7 hours ago. Posted 15 days ago.

Discover Similar Jobs

Suggested Articles