Benefits & Authorization Coordinator - Pharmacy

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

Job Summary

The pharmacy technician promotes medication accessibility and availability to patients in multiple disease states. Their main responsibilities include prescription entry, adjudication of claims, outbound calls to insurance plans, medical offices and patients, prior authorization and coordination of financial assistance.

The Specialty Pharmacy Program Technician reports to the Director of Specialty Pharmacy.Job Description Minimum Qualifications Education: High school diploma or GED. Licenses/Certifications: Licensed as a registered Pharmacy Technician or Pharmacist Intern in the State of Texas.

Experience / Knowledge / Skills:

• Five (5) years experience in specialty, retail, mail order, or hospital pharmacy.

• Demonstrated attention to detail in completing tasks.

• Ability to efficiently complete multiple daily work assignments while operating independently.

• Ability to work cross-functionally to solve problems and improve quality and service.

• Knowledge of medical and pharmaceutical terminology.

• Demonstrated experience in customer service.

• Functional skills with the Microsoft Office Suite of products (Excel, Access, Word, PowerPoint).

• Strong interpersonal and communication skills.

• Experience in specialty pharmacy or pharmacy benefit management preferred.

Principal Accountabilities

• Enters and processes claims accurately, for new/refill prescriptions including resolving rejected claims.

• Works seamlessly in the pharmacy and/or alongside the medical office staff to serve patients both face-to-face and over the phone as needed.

• Reviews all pertinent medical documentation from physician offices and other healthcare facilities.

• Clarifies prescription orders with pharmacist and/or clinician as appropriate.

• Assists to resolve insurance related issues, including prior authorizations (PAs), and assists patients with various forms of financial assistance.

• Assists pharmacist in with the retrieval of prescription files, patient files, and other such records pertaining to the practice of pharmacy.

• Answers, resolves, and triages inbound inquiries on the telephone.

• Performs pharmaceutical calculations.

• Communicates directly with patients to assist them with medication awareness. Reports errors, omissions or incidents to pharmacist.

• Maintains productivity rates and meet quality expectations determined by management. Communicates with various pharmacy team members as needed to coordinate timely prescription dispensing. Participates in staff meetings and helps with special projects. Complies with all regulatory requirements, including HIPAA/HITECH.

• Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.

• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.

• Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.

• Other duties as assigned.