Maryland Oncology Hematology
Pharmacy Tech Authorization Specialist
Maryland Oncology Hematology, Newport News, Virginia, United States, 23600
b>Pharmacy Tech Authorization Specialist
- Maryland Oncology Hematology Virginia Oncology Associates, the largest group of medical professionals in Hampton Roads and Northeast North Carolina devoted exclusively to cancer care and blood disorders, has an exciting opportunity for a Pharmacy Tech Authorization Specialist for our offices in Newport News and Hampton.
Overview Join to apply for the Pharmacy Tech Authorization Specialist role at Maryland Oncology Hematology. Get AI-powered advice on this job and more exclusive features.
Responsibilities
Obtain insurance authorizations and pre‑certification for oral chemo drugs
Apply for financial assistance through cancer foundations and co‑pay assistance for non‑covered or high‑dollar oral drugs
Communicate with medical staff to inform them of any restrictions or special requirements with insurance plans, and documentation or payer issues with non-covered chemotherapy drugs; report any problems or payer trends
Process insurance/patient correspondence, including denial follow‑up, and maintain reimbursement correspondence and filing systems
Assist with review of financial disclosures and negotiate agreement adjustments; provide coverage for patient financial counselors
Act as patient advocate and function as liaison between the patient and payer to answer reimbursement questions and avoid insurance delays
Maintain a good working knowledge of chemotherapy authorization requirements for all payers, as well as state and federal regulatory guidelines for coverage and authorization
Comply with patient confidentiality laws and regulations
Other Duties And Responsibilities
Verify patient demographics, insurance information and prescription information
Process prescription and bill insurance for payment
Review and sign paperwork
Troubleshoot Medicare Part B verification requirements
Submit prior authorizations
Track and report monthly inventory in retail computer
Ensure that the most cost‑effective drugs are ordered from vendors
Label prescriptions and ensure they are checked correctly by providers
Ensure prescriptions and paperwork are being signed off on by a provider
Obtain patient’s signature on all medications being dispensed; files, maintains, and stores prescriptions and daily reports
Qualifications
High school diploma or equivalent
Minimum 3‑5 years of experience in a retail pharmacy setting
Certified Pharmacy Technician certificate or State Pharmacy Board certification required
Minimum two (2) years medical insurance verification/authorization and billing/coding experience preferred
Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. While performing the duties of this job, the employee is regularly exposed to direct contact with patients with potential for exposure to toxic substances, medicinal preparations, and chemotherapeutic agents.
Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye‑hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.
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- Maryland Oncology Hematology Virginia Oncology Associates, the largest group of medical professionals in Hampton Roads and Northeast North Carolina devoted exclusively to cancer care and blood disorders, has an exciting opportunity for a Pharmacy Tech Authorization Specialist for our offices in Newport News and Hampton.
Overview Join to apply for the Pharmacy Tech Authorization Specialist role at Maryland Oncology Hematology. Get AI-powered advice on this job and more exclusive features.
Responsibilities
Obtain insurance authorizations and pre‑certification for oral chemo drugs
Apply for financial assistance through cancer foundations and co‑pay assistance for non‑covered or high‑dollar oral drugs
Communicate with medical staff to inform them of any restrictions or special requirements with insurance plans, and documentation or payer issues with non-covered chemotherapy drugs; report any problems or payer trends
Process insurance/patient correspondence, including denial follow‑up, and maintain reimbursement correspondence and filing systems
Assist with review of financial disclosures and negotiate agreement adjustments; provide coverage for patient financial counselors
Act as patient advocate and function as liaison between the patient and payer to answer reimbursement questions and avoid insurance delays
Maintain a good working knowledge of chemotherapy authorization requirements for all payers, as well as state and federal regulatory guidelines for coverage and authorization
Comply with patient confidentiality laws and regulations
Other Duties And Responsibilities
Verify patient demographics, insurance information and prescription information
Process prescription and bill insurance for payment
Review and sign paperwork
Troubleshoot Medicare Part B verification requirements
Submit prior authorizations
Track and report monthly inventory in retail computer
Ensure that the most cost‑effective drugs are ordered from vendors
Label prescriptions and ensure they are checked correctly by providers
Ensure prescriptions and paperwork are being signed off on by a provider
Obtain patient’s signature on all medications being dispensed; files, maintains, and stores prescriptions and daily reports
Qualifications
High school diploma or equivalent
Minimum 3‑5 years of experience in a retail pharmacy setting
Certified Pharmacy Technician certificate or State Pharmacy Board certification required
Minimum two (2) years medical insurance verification/authorization and billing/coding experience preferred
Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. While performing the duties of this job, the employee is regularly exposed to direct contact with patients with potential for exposure to toxic substances, medicinal preparations, and chemotherapeutic agents.
Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye‑hand coordination. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 40 lbs. Requires corrected vision and hearing to normal range.
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