Job Description
Triage, interpret and input orders into computerized med order system while meeting accuracy and productivity
standards of the pharmacy. Audits input versus documentation and makes corrections as needed
Prepares source data for computer entry by compiling, sorting and verifying information
Ensures completion of necessary information from entry sheets, electronic orders and medication orders for
data entry and account setup in dispensing system. Review and route documents to appropriate department(s)
Verify payers and demographic information. Where applicable, fill in gaps in demographic information. Ability
to research payer benefits and provide residents with information regarding covered and cost-effective
alternatives as appropriate
Working knowledge of drug reimbursement procedures (i.e. benefit investigations, prior authorizations and
letters of medical necessity)
Resolve denials identified through adjudication and follow-up on claims in point of sale (POS)
Maintain current knowledge of Medicaid and Medicare D claim regulations and processes
Be willing to obtain out of state technician license/registration as deemed necessary
Works with responsible parties, receiving in/out bound telephone calls, clarifies and resolves invoice related
inquiries and credit limits
Works with Pharmacy Directors, and Client Billing Services Offices (CBSO) to resolve customer concerns/issues
Works with associates in other functional areas, account management representatives and regional operations
to resolve customer service problems
Performs customer satisfaction calls as needed. Provide excellent customer service to external and internal
customers in accordance with Company values
Works with other functional areas to resolve customer problems, document problems in designated database,
and notify appropriate parties of what action(s) need to be taken
Works under immediate supervision and relies on instructions and pre-established guidelines to perform the
functions of the job
Perform related clerical duties and other tasks as assigned
Education/Learning Experience:
Required: High School Diploma or equivalent
Work Experience:
Required: One-year experience in data entry
Required: One-year experience in customer service
Required: One-year experience in retail pharmacy
Desired: Experience with admissions and collections
Skills/Knowledge:
Required: Ability to communicate effectively. Skilled in operating a computer. Skilled in performing detailed
work
Licenses/Certifications:
Required: State registered/licensed Pharmacy Technician
Desired: National PTCB certification
Behavior Competencies:
Required: Detail orientation; Organization and Planning
