Pharmacy Clerical Specialist
Pharmacy Clerical Specialist-1700027
Required Qualifications: (As Evidenced by Attached Resume)
Associate's degree or In lieu of degree, two (2) years of full time clerical or pharmaceutical experience. Four (4) years of full time clerical office, medical support or pharmacy support experience in a medical office, pharmacy or a health care facility. Knowledge of pharmacy sig codes. Working knowledge of Electronic Medical Record (EMR). Knowledge of medical terminology. Proficient with MS Word and Excel.
Pharmacy technician or LPN with pharmacy experience. Experience with Cerner EMR. Experience with a pharmaceutical delivery scheduling system. Experience liaising with third party pharmaceutical benefit companies. Knowledge of HIPAA rules and regulations. Familiarity with the World Trade Center Health Program (WTCHP).
Brief Description of Duties:
The successful candidate must possess excellent organizational and communication skills and the ability to multi-task. S/he should have a strong sense of responsibility and initiative, use sound judgement in making decisions and have the ability to work independently under minimal supervision. Pharmacy clerical specialist will be responsible for the following duties:
- Address all incoming patient calls regarding their pharmacy prescription requests and prescription questions.
- Communicate with members/patients regarding their pharmacy requests on a daily basis.
- Manage and maintain all prescription requests for patients in the WTCHP.
- Ensure prescription requests are authorized by the provider.
- Enter electronic prescriptions in the pharmacy delivery scheduling system (RXNT).
- Review and process all pharmacy and mail order service prescription requests in Vital Point, the pharmacy benefit manager website.
- Research to determine if a provider should be approved or denied, including: checking to see if the provider is in network, adding them if appropriate and checking to see if we referred the patient to the provider in question.
- Review medications pending in Vital Point (the Pharmacy Benefit Manager website). Submit an approval decision based on whether the patient is certified for the medication, the provider is in network in the WTCHP and the medical rationale and letter of medical necessity is on file for the medication in question.
- Organize pharmacy medication types regarding brand/generic utilization statistics for inclusion in the monthly Quality Assurance (QA) reports provided to the National Institute of Occupational Safety and Health (NIOSH).
- Input drug exclusions (block medications) in patient profiles via Vital Point based on the findings by each provider from the QA reports.
- Track and process prior authorizations.
- Notify providers of existing drug Prior Authorizations and their category (level 2 or level 3) required for the patient's medications based on patient certification.
- Receive forms for Prior Authorizations and process overrides once approved so that patients can acquire their medications.
- Communicate directly with Vital Point personnel and Pharmacists as needed regarding other overrides for patient's medications, requests for additions to WTCHP formulary, etc.
- Assist with resolving billing issues encountered at pharmacies and mail-order service and when allowable, assist in getting reimbursed for pharmacy billing errors.
- Other duties as required.
Special Notes: This position is located in our Commack facility. This is a full time appointment. FLSA Nonexempt position, eligible for the overtime provisions of the FLSA.
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Official Job Title: Clerical Specialist II
Job Field: Clerical/Secretarial
Primary Location: US-NY-Commack
Department/Hiring Area: Medicine - WTCHP-The Research Foundation for The State University of New York at Stony Brook
Schedule: Full-time Day Shift 8:30 a.m. - 4:30 p.m.Medicine - WTCHP-The Research Foundation for The State University of New York at Stony Brook
Posting Start Date: Aug 11, 2017
Posting End Date: Aug 25, 2017, 10:59:00 PM
Salary: $38,000-$45,000 / Annual @ 1.0 FTE CWE
Salary Grade: N7