Summary:
Following a training period of approximately 4 to 6 weeks, the Outpatient Technician Coordinator should be able to decipher and enter MSOT prescriptions in EPIC, process test claims and determine insurance eligibility, process prior authorizations, help obtain financial assistance and coordinate patients access to medication.
Technician is also responsible for answering phones, capturing payment, documentation, and coordinating the entire patient medication access process. Technician coordinator will facilitate scheduling/coordination of ongoing medication fills as appropriate. Position requires professional judgment, legendary customer service and problem-solving skills.
Work location will be between outpatient pharmacy and the specialty office. Technician will need to become proficient in all specialty disease states and work collaboratively with other coordinators and pharmacist team to ensure safe, quality efficient patient care.
Responsibilities:
(25%) *Gather insurance information and work with doctor's offices, nurses, pharmacies, and caseworkers to coordinate medication needs. This includes coordinating everything from the point of prescribing to the receipt of medication by the patient. Prescriptions will be adjudicated; prior authorizations and financial assistance obtained with set performance expectations for cost and turnaround time. Adherence to Specialty accreditation standards and requirements and all legal and regulatory best practices and requirements is mandatory.
(25%) *Ensure patients remain on track with medication regimens-outbound therapy/medication adherence check-ups and coordination of refills.
(25%) *Communicate effectively with centralized support personnel and outpatient pharmacy staff to ensure all tasks are completed timely for optimized patient experience. Answer, resolve and triage inbound inquiries.
(25%) *Gather, review, and interpret information from the electronic medical record (EMR) and from other disciplines (nursing, case management, pharmacy etc.) to determine appropriate next steps. Appropriate documentation in all required systems for seamless care and compliance.
Answer questions from nursing, case management, patients, pharmacy and physicians regarding coverage, prior authorization, funding, payment & prescription status.
Process prior authorizations and financial assistance in a timely manner meeting set metrics.
Work with case management and other resources (manufacturer, foundations etc.) to assist patients who struggle with prescription costs (including those without prescription insurance coverage). This includes looking at free drug options, offering prescriptions for cash price, suggesting financial assistance or repository when eligible.
Identify trends, resolve problems, recommend improvements, implement change.
Will be required to staff in a technician capacity including filling and dispensing roles when needed/requested.
Other duties as assigned.
Certifications and Licensures:
PHARM TECH: Pharmacy Technician Licensure
Equivalent Experience: New hires and transfers before October 1, 2015, must possess a full technician license or limited pharmacy license through the state of Michigan. Effective October 1, 2015, all incumbents, new hires and transfers to this position must possess a pharmacy technician temporary, limited or full license through the state of Michigan. Individuals with a temporary license through the state of Michigan within 12 months of obtaining the temporary license.
Required Education:
High School Diploma or GED
Other Information:
Computer experience required.
Good math skills (pass a standard test), good organizational skills, detail oriented, a team player and ability to work under high pressure and time constraints are all required.
Must be able to work independently and establish strong and credible relationships with patients, clinicians, pharmacy and specialty vendor staff.
Interpersonal skills needed to communicate successfully with individuals and groups and interact with people at all levels to communicate ideas and concepts in a clear and understandable manner. Mature, empathetic, approachable, professional and comfortable in dealing with others both in person and on the phone.
MyMichigan Health is a technology driven organization and employees need to demonstrate competency in Microsoft Windows. An employee may be required to participate in further learning opportunities offered by MyMichigan Health.
Medical Terminology knowledge preferred. Hospital, billing and Retail Pharmacy experience preferred.
Exposure to stressful situations, including those involving public contact, as well as trauma, grief and death. Able to wear personal protective equipment that includes latex materials or appropriate substitute if required for your position.
Is able to move freely about facility with or without an assisted device and must be able to perform the functions of the job as outlined in the job description.
Overall vision and hearing are necessary with or without assisted device(s).
Frequently required to sit/stand/walk for long periods of time. May require frequent postural changes such as stooping, kneeling and crouching.
Some exposure to blood borne pathogens and other potentially infectious material. Must follow MyMichigan Health bloodborne pathogen and TB testing as required.
Ability to handle multiple tasks, get along with others, work independently, regular and predictable attendance and ability to stay awake.
Overall dexterity is required including handling, reaching, grasping, fingering and feeling. May require repetition of these movements on a regular to frequent basis.
Physical Demand Level: Light. Must be able to occasionally (0-33% of the workday) lift or carry 11-20 lbs., frequently (34-66% of the workday) 10 lbs. and or Walk/Stand/Push/Pull of Arm/Leg controls.
Equivalent Experience and Other Comments (Education):
Other Comments:
