Pharmacy Tech Authorization Specialist

PRIMARY DUTIES:

• Obtain insurance authorizations and pre-certification for oral chemo drugs
• Applies for financial assistance through cancer foundations and co-pay assistance for non-covered or high dollar oral drugs
• Communicate with medical staff to inform them of any restrictions or special requirements with insurance plans, and documentation or payer issues with non-covered chemotherapy drugs; report any problems or payer trends
• Process insurance/patient correspondence, including denial follow-up, and maintain reimbursement correspondence and filing systems
• Assist with review of financial disclosures and negotiate agreement adjustments; provide coverage for patient financial counselors.
• Act as patient advocate and function as liaison between the patient and payer to answer reimbursement questions and avoid insurance delays
• Maintain a good working knowledge of chemotherapy authorization requirements for all payers, as well as state and federal regulatory guidelines for coverage and authorization
• Comply with patient confidentiality laws and regulations

• High School diploma or equivalent.

• Minimum 3-5 years of experience in a retail pharmacy setting.
• Certified Pharmacy Technician certificate or State Pharmacy Board required.
• Minimum two (2) years medical insurance verification/authorization and billing/coding experience preferred.

WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. While performing the duties of this job, the employee is regularly exposed to direct contact with patients with potential for exposure to toxic substances, medicinal preparations, and chemotherapeutic agents.

PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.