- Knowledge of QS!
- Ability to read and interpret prescriptions.
- Familiar with third party payers and Managed Care Pharmacy claim processing. Decipher, understand adjudication claim rejections and resolve pertaining issues.(Preferred)
- Receive/respond to provider and patient calls regarding the prior authorization and Plan’s formulary process to ensure smooth patient care.
- Arranges work activities so that the pharmaceutical needs of patients are met.
- Participate in company (QI) Quality Improvement activities as required.
- Responsible for the overall coordination and processing of patient medication orders, to include order intake within regulatory boundaries, customer service coordination, and pharmacy technician duties as defined by policy and regulation and while under the supervision of a pharmacist.
- Process prescription refills to include: refill confirmation when appropriate, review pending refills with the supervising pharmacist, generate refill documentation and process third party claims adjudication within the assigned work que in a timely & accurate manner.
- Communicate as necessary with patients to determine general health status, medication compliance, drug and supply inventory, and overall coordination of care and service (custom assessment in software system) as applicable.
- Ability to transition medication order through medication order tracking software at every step of the medication dispensing process.
- Gather, organize, document, and report clinical data for review and action by the patient care team (pharmacist, nurse, prescriber, as applicable) to include: lab data as applicable, results of patient contact documented on the custom assessment and hospitalizations.
- Ability to generate and schedule medication deliveries accurately to meet lead-time and delivery deadlines.
- Answer telephone and fulfill patient refill(s) request and related pharmacy business.
- Performs related duties as assigned or requested.
- Contributing to team effort and willingness to be flexible to support dynamic needs of a small growing company. Ability to perform other duties and tasks as assigned by Management.
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