Pharmacy Technician II - Patient Assistance Program and Prior Authorizations
Duke University Health System
Location: Durham, North Carolina
Internal Number: 150508
Duke University Hospital is consistently rated as one of the best in the United States and is known around the world for its outstanding care and groundbreaking research. Duke University Hospital has 957 inpatient beds and offers comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center; a major surgery suite containing 51 operating rooms; an endo-surgery center; an Ambulatory Surgery Center with nine operating rooms and an extensive diagnostic and interventional radiology area. In fiscal year 2018, Duke University Hospital admitted 42,916 patients and had 1,085,740 outpatient visits in fiscal year 2017.
U.S News & World Report named Duke University Hospital #1 in North Carolina and #1 in the Raleigh-Durham area in 2018-19.
Duke University Hospital is ranked in the top 20 nationally for seven adult specialties, including cardiology and heart surgery, nephrology, ophthalmology, orthopedics, pulmonology, rheumatology, and urology.
In addition to its hospitals, Duke Health has an extensive, geographically dispersed network of outpatient facilities that include primary care offices, urgent care centers, multi-specialty clinics and outpatient surgery centers.
Location: Duke Hospital, Durham, North Carolina
This pharmacy technician will complete medication Prior Authorizations and participate in the Patient Assistance Program for the Department of Pharmacy ensuring patient access to prescribed medications and drug accountability for drug replacement programs and manufacturer assistance programs in compliance with hospital, state, and federal requirements. This position will also coordinate drug delivery and continuity of care with Duke Retail Pharmacies. This pharmacy technician will primarily be based out of their assigned specialty clinic and will support medication prior authorizations and patient assistance for various patient populations.
· Receive referrals to complete medication prior authorizations from clinic staff, providers, and patients
· Verify prescription insurance benefits and/or medical benefits are currently active for patients
· Complete benefits investigations to determine coverage level and patient responsibility
· Submit required forms and documentation to insurance companies via phone/fax and/or web portals
· Follow up on requests to receive determination decisions in a timely manner
· Communicate and document all status updates to patients, providers, and pharmacies
· Assists self-pay and underinsured patients in obtaining costly medications primarily from drug manufacturer replacement programs and manufacturer assistance programs.
· Coordinates and assists the clinic financial care counselors and social workers in identifying eligible patients.
· Works with the Patient Revenue Management Organization to assist in drug replacement for insured patients with drug denials.
· Forwards credits to Pharmacy Financial Management Team for assisted patients.
· Interviews potential patients for assistance and collect all financial forms related to the self-pay status.
· Prepare prescriptions for a pharmacist to check pursuant to a physician order.
· Inputs patient information (including insurance information) into WAM.
· Works with clinical pharmacists to follow patient management program requirements
· Provides input into and participates in quality improvement activities
· Other duties as appropriate for this position
Knowledge, Skills, and Abilities:
Excellent communication skills, Microsoft Word and Excel competence, organizational skills, ability to multitask and work independently.
Work requires high school or equivalent. Successful completion of a formalized Pharmacy Technician program preferred.
Work requires a minimum of two years experience as a Pharmacy Technician plus completion of advanced competencies checklist as documented and approved by the Department of Pharmacy. OR AN EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND/OR EXPERIENCE.
Degrees, Licensures, Certifications
Pharmacy technician certification is required from the Pharmacy Technician Certification Board (PTCB). North Carolina Board of Pharmacy registration is required.
Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
As a world-class academic and health care system, Duke Health strives to transform medicine and health locally and globally through innovative scientific research, rapid translation of breakthrough discoveries, educating future clinical and scientific leaders, advocating and practicing evidence-based medicine to improve community health, and leading efforts to eliminate health inequalities.