Job description
Responsibilities:
- Enter new patient and provider information accurately into the pharmacy MIS.
- Review contents of referrals to ensure complete and accurate information has been received and entered into the pharmacy system. Communicate with providers to obtain missing information when necessary.
- Locate and enter accurate prescription insurance information on patient’s profile by processing eligibility checks and adjudicating pharmacy claims.
- Adjudicate claims and troubleshoot rejections so that the correct information is communicated to the patient
- Communicate the need for medication prior authorization (PA) to providers and serve as a resource to the provider during the PA process.
- Manage inbound calls from patients, clients, physicians, practitioners and clinics regarding inquiries about order status, services provided, financial support options
- Serve as a technical resource pertaining to adjudication while identifying areas for improvement.
- Entering detailed, accurate, and grammatically correct progress notes to ensure proper documentation on patient profiles.
- Contact patients to schedule medication delivery and payment so that accurate information is included in their profile and distribution can successfully send their package in a timely manner
- Manage patient refill coordination and follow-up to ensure patients comply with their therapy plan
- Identify and report adverse events (AEs) and product complaints (PCs) to clinicians to ensure patient’s safety
- Perform other duties as assigned (above tasks may vary slightly depending on the specific team/program requirements.)
Minimum Requirements:
- CPhT (Certified Pharmacy Technician) certification preferred.
- Must be current, without restrictions, and in good standing
- 5+ years prior experience working in a pharmacy or other health care setting required
- Experience with insurance eligibility and prior authorization processes
- Competent in basic computer skills and proficiency in Microsoft applications
- Conscientious, detail oriented with the ability and desire to solve problems to help our patients
- Flexible, adaptable, and the ability to effectively work in a team setting to accomplish a common goal
- Highly motivated and committed to excellence with a positive attitude
About McKesson.com:
Currently ranked 7th on the FORTUNE 500, we are a global leader in healthcare supply chain management solutions, retail pharmacy, healthcare technology, community oncology and specialty care. We partner with life sciences companies, manufacturers, providers, pharmacies, governments and other healthcare organizations to help provide the right medicines, medical products and healthcare services to the right patients at the right time, safely and cost-effectively. United by our ICARE shared principles, our employees work every day to innovate and deliver opportunities to improve patient care in every setting — one product, one partner, one patient at a time.
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