The US Oncology Network
Pharmacy Tech Authorization Specialist
The US Oncology Network, Newport News, Virginia, United States, 23600
Overview
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.
Please take this quick survey once you've submitted your resume to complete the application process: Pharmacy Tech Authorization Survey. If you have completed the survey before, even for another position, please do not take it again.
Responsibilities
Obtain insurance authorizations and pre‑certification for oral chemotherapy 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.
Verifies patient demographics, insurance information and prescription information.
Processes prescription and bills insurance for payment.
Reviews and signs paperwork.
Troubleshoots Medicare Part B verification requirements.
Submits prior authorizations.
Tracks and reports monthly inventory in retail computer.
Ensures that the most cost‑effective drugs are ordered from vendors.
Labels prescriptions and ensures they are checked correctly by providers.
Ensures prescriptions and paperwork are being signed off on by a provider.
Obtains 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 of 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. The employee is regularly exposed to direct contact with patients with potential for exposure to toxic substances, medicinal preparations, and chemotherapeutic agents.
Physical Demands 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 lb. Requires corrected vision and hearing to normal range.
Additional Information Location: Hampton, VA. Salary: $93,400.00–$161,000.00.
#J-18808-Ljbffr
Please take this quick survey once you've submitted your resume to complete the application process: Pharmacy Tech Authorization Survey. If you have completed the survey before, even for another position, please do not take it again.
Responsibilities
Obtain insurance authorizations and pre‑certification for oral chemotherapy 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.
Verifies patient demographics, insurance information and prescription information.
Processes prescription and bills insurance for payment.
Reviews and signs paperwork.
Troubleshoots Medicare Part B verification requirements.
Submits prior authorizations.
Tracks and reports monthly inventory in retail computer.
Ensures that the most cost‑effective drugs are ordered from vendors.
Labels prescriptions and ensures they are checked correctly by providers.
Ensures prescriptions and paperwork are being signed off on by a provider.
Obtains 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 of 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. The employee is regularly exposed to direct contact with patients with potential for exposure to toxic substances, medicinal preparations, and chemotherapeutic agents.
Physical Demands 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 lb. Requires corrected vision and hearing to normal range.
Additional Information Location: Hampton, VA. Salary: $93,400.00–$161,000.00.
#J-18808-Ljbffr