Specialty Pharmacy Technician & Billing Coordinator (On-Site) - Cardinal Health

What Individualized Care contributes to Cardinal Health

The Specialty Pharmacy Technician & Benefits Coordinator is responsible for completing necessary functions to ensure optimal reimbursement for high-cost medications in a specialty, outpatient pharmacy. Duties and responsibilities include: performing tasks related to the management of third-party billing, insurance verification, prior authorizations, and financial support.

Other responsibilities include supporting multiple facets of the pharmacy such as accuracy and proficiency in data entering, coordination of medication refills via telephone, filling of specialty medications, ordering, appropriate packaging and shipments of medications, and delivering exceptional customer service.

Location: Lewiston, ME

Hours: 8am-4:30pm Monday-Friday

Responsibilities:

• Accurately enter in prescriptions to the pharmacy’s electronic system.

• Review and screen new patients at intake to determine if patient has adequate prescription coverage.

• Provide customer service and monthly adherence calls through the telephone.

• Function as primary third-party billing resource for Outpatient pharmacy staff.

• Troubleshoot and resolve billing rejections and subsequently rebill claims to appropriate carrier for all commercial, federal, and state insurance plans.

• Submit prior authorization requests, follow up on prior authorization requests, and submit claims with approvals as appropriate.

• Identify patients who may qualify for patient medication assistance programs, grants or copay assistance.

• Contact payers for lost medication overrides, replacement, and vacation override approvals.

• Assist with prescription audits.

• Establish and maintain good working relationships with specialty Outpatient Clinic staff to maintain effective communication regarding third-party billing issues.

• Assist in the development, implementation, and evaluation of third-party billing policies and procedures.

• Educate pharmacy staff about third-party billing policies and procedures as needed.

• Draft various correspondence letters and send to referral source when necessary.

• Gather and document demographics, insurance information, needs assessment, and other data.

• Communicate the anticipated self-pay portion (co-payments/deductibles/co-insurance) with patients and establish payment arrangements based on the Financial Policy and document the financial resolution in the registration/billing systems.

• Participate in ordering of medications and pharmacy supplies.

• Assist in filling all specialty medications.

• Participate in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth.

• Participate in performance and quality improvement activities as assigned by Specialty Pharmacy Manager.

• Assist in oversight of compliance of the 340B Drug Discount Program.

• Ensure appropriate storage of all medications and assist patients with accurate delivery of medication via courier, pharmacy pick-up, or mail.

Qualifications

• Previous customer service experience required
• Current licensure as a Pharmacy Technician in the state of Maine
• High School diploma or equivalent preferred
• Experience conducting and documenting patient health insurance benefit investigations, prior authorizations, and appeals is preferred
• Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies is preferred
• Critical and creative thinking is a must
• Knowledge of 340B is preferred
• Important to have a strong attention to detail

Anticipated hourly range: $21.20 per hour - $30.20 per hour

Bonus eligible: No

Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

• Medical, dental and vision coverage
• Paid time off plan
• Health savings account (HSA)
• 401k savings plan
• Access to wages before pay day with myFlexPay
• Flexible spending accounts (FSAs)
• Short- and long-term disability coverage
• Work-Life resources
• Paid parental leave
• Healthy lifestyle programs

Application window anticipated to close: 04/11/2024 *if interested in opportunity, please submit application as soon as possible.

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.