Position Summary: 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 QS1.
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.
Experience and Desired Credentials: Registered with the NC Board of Pharmacy, Certified as a Pharmacy Technician (PTCB), high school diploma or equivalent, completion of a certified pharmacy technician program and two years hospital experience as a pharmacy technician.
Duke University 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 essential job 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.
Internal Number: 401583709
About Duke University Health System
Duke Health conceptually integrates the Duke University School of Medicine, Duke-NUS Medical School, Duke University School of Nursing, Duke University Health System, Private Diagnostic Clinic (Duke physicians practice), and incorporates the health and health research programs within the Duke Global Health Institute as well as those in schools and centers across Duke University, including the Duke Robert J. Margolis Center for Health Policy.
Duke Health is committed to conducting innovative basic and clinical research, rapidly translating breakthrough discoveries to patient care and population health, providing a unique educational experience to future clinical and scientific leaders, improving the health of populations, and actively seeking policy and intervention-based solutions to complex global health challenges. Underlying these ambitions is a belief that Duke Health is a destination for outstanding people and a dedication to continually explore new ways to help our people grow, collaborate and succeed.