Pharmacy Technician III
1 week ago
Penn Medicine is dedicated to delivering exceptional patient care and advancing medical research. As a Pharmacy Technician III, you will play a vital role in ensuring seamless patient care by providing pre-certification and referrals for inpatient and same-day encounters. Your expertise will be instrumental in verifying benefits, pre-certifying outpatient registrations, and providing specialized support in insurance and billing information. You will work closely with our team to resolve problems and answer questions, ensuring access to integrated healthcare and optimal reimbursement for our services.
Key Responsibilities:
- Determine patients' insurance requirements for pre-certification, patient payments, and coverage limitations, and take necessary actions prior to patient discharge.
- Maintain communication with unit-based clinical pharmacists, social workers, and discharge pharmacy program administrators to obtain complete and accurate financial information required for claim adjudication.
- Fax all necessary information to insurance companies to obtain authorization numbers for pre-certification and communicate these numbers to discharge concierge program staff to facilitate prescription processing and filling.
- Support all Concierge Service-related activities from prescription intake to bedside delivery at time of patient discharge when required.
- Assist in establishing policies and procedures specific to the financial aspects of the Concierge Services Program, including indigent drug programs, patient assistance programs, and pre-certification standard operating procedures.
- Collaborate with internal team members to gather appropriate paperwork, prescriptions, billing information, and prescriptions.
- Provide follow-up communication to patients and families for pharmaceutical needs and additional eligibility information to ensure ongoing medication access.
- Interact with medical staff and their designees to obtain complete, accurate, and timely clinical and financial information required for payer reimbursement.
- Collaborate with internal team members, insurance companies, drug manufacturers, and prescription benefit administrators to coordinate drug coverage or resolve denials.
- Provide education to Pharmacy, Patient Financial Counselors, and Care Coordination regarding current policy and process as it pertains to the patient assistance program and pharmacy exception process.
- Follow up with all review companies on all pending authorizations and referrals.
- Access coverage and determine payments due from patients.
- Coordinate payment collection.
- Maintain excellent working relationships with all insurance companies.
- Communicate and maintain excellent working relationships with referring physicians and their staff.
- Work approximately one week in advance whenever possible.
- Provide accurate information to billing and case management to ensure payment of claims.
- Accept responsibility and demonstrate positive and competent performance.
- Provide ongoing education and exhibit a willingness to share current knowledge with team members as necessary to help meet organizational goals.
- Maintain current knowledge about pre-certification processes for all Federal, State, and third-party payors.
- Identify systems issues impacting the use of resources.
- Pharmacy Technician Certification (Required)
High School Diploma with 3-5 years' experience in a community-based retail or hospital outpatient pharmacy environment or a financial coordinator. We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives. We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran, or any other status protected by applicable law.
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