Pharmacy Benefits Specialist

4 weeks ago

West Bloomfield, United States Henry Ford Hospital Full time

GENERAL SUMMARY:

This Employee will work with both outpatient pharmacy and inpatient

Eligible for Sign-on bonus of 2,500

The Pharmacy Benefits Specialist is responsible for handling drug claim adjudication issues, prescription prior authorization, and pharmacy benefit inquiries from

members/patients, physicians, pharmacies, and other internal and external individuals. Is a subject matter expert in the resolution of pharmacy benefit coverage issues and coordinating prior authorization and exception processes.

PRINCIPLE DUTIES AND RESPONSIBILITIES:

* This employee will work with both outpatient pharmacy and inpatient.
* Outpatient pharmacy: Verifies patient prescriptions benefits, including medical and pharmacy coverage, to ensure accurate billing and reimbursement.
* Inpatient pharmacy: works in the ER department with inpatient pharmacy to complete medication history for patients admitted to the hospital.


* Performs benefits investigation, prescription prior authorization, and research financial assistance needed to ensure patients have access to medications needed.
* Acts as a central resource to manage and monitor all medication related inquiries from providers/clinics.
* Interprets patient treatment plans and medical notes for purposes of facilitating patient care.
* Evaluates any pharmacy related inquiries (i.e., financial barriers, therapy management related outcomes, non-adherence to therapy) and communicates with nursing, providers, social workers and physician staff any additional requirements or potential barriers to the treatment plan.
* Performs all necessary steps during order entry to ensure order gets to final verification. Ensures the process is completed quickly, accurately, and in accordance with patient's needs while maintaining the highest customer service/quality of care.
* Performs online ordering of prescriptions submitted to pharmacies.

This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and duties. It should be understood, therefore, that employees may be asked to perform job-related duties beyond those explicitly described above.

EDUCATION/EXPERIENCE REQUIRED:

* Requires a High school diploma or G.E.D. Associates degree preferred.
* Requires State of Michigan Pharmacy Technician License.
* Requires a minimum of two years of previous pharmacy technician experience.
* Previous experience as a specialty pharmacy technician preferred.
* Knowledge in the specialty disease states (Oncology, Autoimmune Disease, Neurology, Hepatology, other miscellaneous Specialty Diseases) preferred.
* Knowledge of benefits investigation, prior authorization support, and patient financial assistance work preferred.
* Requires a strong understanding and knowledge of medical/clinical and pharmacy terminology.
* EMR systems (Epic or Cerner), dispensing systems (McKesson Enterprise, QS1, or RX30) and specialty pharmacy patient management programs (Asembia-1, Therapy, or Dromos PTM) experience is preferred.

Additional Information

* Organization: Community Care Services
* Department: Ambulatory Pharmacy West Bloom
* Shift: Rotating
* Union Code: Not Applicable

  • Pharmacy Benefits Specialist

    4 weeks ago

    West Bloomfield, United States Henry Ford Health System Full time

    GENERAL SUMMARY: **This Employee will work with both outpatient pharmacy and inpatient** **Eligible for Sign-on bonus of 2,500** The Pharmacy Benefits Specialist is responsible for handling drug claim adjudication issues, prescription prior authorization, and pharmacy benefit inquiries from members/patients, physicians, pharmacies, and other...

  • Pharmacy Billing Specialist

    5 days ago

    West Norriton, United States Synergy Pharmacy Services Full time

    **Job description** **Pharmacy Billing Specialist** Schedule: Monday through Friday, 7:30 am to 4:00 pm, in a professional office **Responsibilities**: - Adjudicate, move, and work daily prescription rejections timely. - Batch and submit cycle prescriptions to third party payers, resolve all denials before prescriptions are delivered. - Process daily...

  • Pharmacy Technician

    2 weeks ago

    Bloomfield, United States MORRIS PLAZA PHARMACY LLC Full time

    Job DescriptionJob DescriptionBenefits:401(k) matchingCompetitive salaryFlexible scheduleHealth insurancePaid time offTraining & developmentWellness resources Job Title: Pharmacy TechnicianPharmacy Name: Icare PharmacyLocation: 194 Broad Street B, Bloomfield, NJ - 07003Position Type: Full-Time Immediate Joining PreferredJob Description:Icare Pharmacy in...

  • Pharmacy Technician

    2 weeks ago

    Bloomfield, United States MORRIS PLAZA PHARMACY LLC Full time

    Job DescriptionJob DescriptionBenefits:401(k) matchingCompetitive salaryFlexible scheduleHealth insurancePaid time offTraining & developmentWellness resources Job Title: Pharmacy TechnicianPharmacy Name: Icare PharmacyLocation: 194 Broad Street B, Bloomfield, NJ - 07003Position Type: Full-Time Immediate Joining PreferredJob Description:Icare Pharmacy in...

  • Pharmacy Technician

    2 weeks ago

    Bloomfield, United States MORRIS PLAZA PHARMACY LLC Full time

    Job DescriptionJob DescriptionBenefits:401(k) matchingCompetitive salaryFlexible scheduleHealth insurancePaid time offTraining & developmentWellness resources Job Title: Pharmacy TechnicianPharmacy Name: Icare PharmacyLocation: 194 Broad Street B, Bloomfield, NJ - 07003Position Type: Full-Time (Immediate Joining Preferred)Job Description:Icare Pharmacy in...

  • Pharmacy Technician

    2 weeks ago

    Bloomfield, United States MORRIS PLAZA PHARMACY LLC Full time

    Job DescriptionJob DescriptionBenefits:401(k) matchingCompetitive salaryFlexible scheduleHealth insurancePaid time offTraining & developmentWellness resources Job Title: Pharmacy TechnicianPharmacy Name: Icare PharmacyLocation: 194 Broad Street B, Bloomfield, NJ - 07003Position Type: Full-Time (Immediate Joining Preferred)Job Description:Icare Pharmacy in...

  • Pharmacy Technician

    4 weeks ago

    West Chester, United States CSI Pharmacy Full time

    Job Title Pharmacy Technician (PDP Insurance) Location West Chester, OH, USA Additional Location(s) Employee Type Employee Working Hours Per Week 40 Job Description CSI Pharmacy is hiring a PDP Insurance Billing Specialist to join our dynamic team. CSI Pharmacy is a nationwide specialty pharmacy, founded by pharmacists and dedicated to providing services...

  • Pharmacy Technician Compounding Specialist

    3 months ago

    West Hollywood, United States National Pharmacy Full time

    **Compounding Pharmacy in West Hollywood looking to hire an experienced compounding Pharmacy Technician.** **Responsibilities**: - Supports pharmacological services by stocking, assembling, and distributing medications. - Helps health care providers and patients by greeting them in person and by phone, answering questions and requests, and referring...

  • Pharmacy Technician

    2 weeks ago

    West Hills, United States Oak Hills Medical Pharmacy Full time

    **About us** Oak Hills Medical Pharmacy is a small business in West Hills, CA. We are professional, agile and our goal is to combine personalized care with unmatched service. We strive to serve our local community as best we can by providing a vast range of pharmaceutical services.. Our work environment includes: - Modern office setting Oak Hills Medical...

  • Pharmacy Technician

    3 weeks ago

    West Chester, United States CSI Pharmacy Full time

    CSI Pharmacy is hiring a PDP Insurance Billing Specialist to join our dynamic team. CSI Pharmacy is a nationwide specialty pharmacy, founded by pharmacists and dedicated to providing services for patients with chronic and rare illnesses that require complex care. This role will be based out of our West Chester, OH office.The PDP Insurance Billing Specialist...

  • Pharmacy Technician

    3 weeks ago

    West Chester, United States CSI Pharmacy Full time

    Job DescriptionCSI Pharmacy is hiring a PDP Insurance Billing Specialist to join our dynamic team. CSI Pharmacy is a nationwide specialty pharmacy, founded by pharmacists and dedicated to providing services for patients with chronic and rare illnesses that require complex care. This role will be based out of our West Chester, OH office.The PDP Insurance...

  • Benefit Administration Specialist

    2 weeks ago

    Bloomfield Hills, Michigan, United States Austin Benefits Group Full time

    Austin Benefits group is a leading employee benefits firm that provides benefit solutions to both private and publicly traded companies. We provide our clients with a highly responsive team to deliver unmatched service, education and smart benefit solutions. Austin Benefits is currently looking for a new member to join our team as a full time Benefit...

  • Benefit Administration Specialist

    4 weeks ago

    Bloomfield Hills, United States Austin Benefits Group Full time

    Job DescriptionJob DescriptionSalary: Austin Benefits group is a leading employee benefits firm that provides benefit solutions to both private and publicly traded companies. We provide our clients with a highly responsive team to deliver unmatched service, education and smart benefit solutions.Austin Benefits is currently looking for a new member to join...

  • Hospital Pharmacy Technician

    3 weeks ago

    West Allis, Milwaukee County, WI, United States Jackson Pharmacy Full time

    Jackson Pharmacy Professionals is currently hiring for a full-time Hospital Pharmacy Technician. This is a great opportunity for a PTCB Pharmacy Technician interested gaining hospital experience as no experience is required for consideration. The team is looking for a hard working team-player, eager to learn. contract role. This is an immediate position...

  • Hospital Pharmacy Technician

    3 weeks ago

    West Allis, United States Jackson Pharmacy Full time

    Jackson Pharmacy Professionals is currently hiring for a full-time Hospital Pharmacy Technician. This is a great opportunity for a PTCB Pharmacy Technician interested gaining hospital experience as no experience is required for consideration. The team is looking for a hard working team-player, eager to learn. contract role. This is an immediate position...

  • Pharmacy Technician Specialist

    3 weeks ago

    West Bloomfield, United States Henry Ford Health System Full time

    GENERAL SUMMARY: Under the direction of the Department Director or Manager, coordinates and facilitates operations in key department areas such as automation and information services, pharmaceutical waste management, regulatory readiness, purchasing and inventory control, controlled substances diversion monitoring, and other duties and responsibilities as...

  • Hospital Pharmacy Technician

    3 weeks ago

    West Trenton, United States Jackson Pharmacy Full time

    Jackson Pharmacy Professionals is one of the nation's leading pharmacy specific staffing and placement agencies! We're currently hiring for Hospital Pharmacy technicians for a contract position in Trenton, NJ! Our ideal candidate will be interested in a career opportunity with a leading hospital system. PTCB certified candidate are encouraged to...

  • Pharmacy Clerk

    4 weeks ago

    West Haven, United States West Haven Pharmacy Full time

    We are hiring Pharmacy Clerk with a desire to learn and expand their knowledge of the pharmacy technician role. No prior experience in pharmacy is required: only a great attitude and a strong desire to learn. Over the course of your first 90 days, we will train and equip you with the necessary skills to become a successful technician. What you’ll do: -...

  • Pharmacy Technician

    3 weeks ago

    West Chester, OH, United States CSI Pharmacy Full time

    CSI Pharmacy is hiring a PDP Insurance Billing Specialist to join our dynamic team. CSI Pharmacy is a nationwide specialty pharmacy, founded by pharmacists and dedicated to providing services for patients with chronic and rare illnesses that require complex care. This role will be based out of our West Chester, OH office.The PDP Insurance Billing Specialist...

  • Assistant Pharmacy Director

    4 weeks ago

    West Chester, United States Jackson Pharmacy Full time

    Jackson Pharmacy Professionals is the one of the nation's leading pharmacy-specific staffing and placement companies. We are currently hiring for a LTC Assistant Pharmacy Director (Pharmacist) for a leading LTC pharmacy. Our ideal candidate will be available to work full-time, and available ASAP. Apply today for immediate consideration! $62+/hr DOE. ...