Job description
LifeSpan Pharmacy, a CarDon & Associates partner, is now seeking an Order Entry Tech. Weekly pay and great benefits!
EDUCATION, QUALIFICATIONS, CREDENTIALS:
- Associate degree in health-related field or 1-2 years direct work experience in health related field
- Understanding of Medicare/Medicaid/Insurance Pay types, medical terminology, and brand/generic medications required
- Working knowledge of Microsoft Word and Excel, or like applications
RESPONSIBLE TO: Operations Manager
ESSENTIAL FUNCTIONS:
I. Prescription processing (80%)
- Data Entry of new and refill orders which includes:
2. Identifies orders that cannot be processed due to coverage issues, missing information, or inability to read/understand
3. Inputs medication orders with correct medication and frequency. Minimum requirement is 30 orders per hour.
4. Ensures formulary substitutions are made appropriately based on facility contracts
5. Completes appropriate paperwork/forms, as well as communicating order exceptions and any other discrepancies to facilities and team leaders
6. Transmit all third party and Medicaid online claims at time of order entry to ensure payment as well as dispensing fee.
7. Maintains an understanding of the special requirements for each payer including Medicare/Managed Care/Medicaid Formulary and Non-Formulary/Third Party Insurance as well as communicate discrepancies to facilities regarding:
- Formularies
- Rejections
- Contract requirements
- Exclusions and Non-covered medications
9. Researches and communicates with facility regarding any processing and reimbursement issues with order
II. Admission/Readmission of residents to Pharmacy System (15%)
- Process new admission/readmission information for residents:
1. Reviews admissions and enters correct admission pay type information into Pharmacy system calling facility when pay type information not available
2. Collects information from facilities regarding resident insurance cards, social security number, guarantor demographics, room number, wing, allergies, diagnosis, verifies patient medication needs, etc.
3. Verifies Insurance/Medicaid eligibility
4. Identifies orders that cannot be processed due to coverage issues, missing information, or inability to read/understand
5. Communicates with facility and Third-party providers to get necessary coverage, missing information etc. to correct order to be processed
6. Input of medication orders with correct medication and frequency
7. Ensures formulary substitutions are made appropriately based on facility and third-party provider contracts
8. Completes appropriate paperwork/forms, as well as communicating order exceptions and any other discrepancies to facilities, third party providers, and team leaders
9. Transmit all third party and Medicaid online claims at time of order entry to ensure payment as well as dispensing fee.
10. Documents all admits/readmits processed on the admission log
2. Collects information from facilities regarding resident insurance cards, social security number, guarantor demographics, room number, wing, allergies, diagnosis, verifies patient medication needs, etc.
3. Verifies Insurance/Medicaid eligibility
4. Identifies orders that cannot be processed due to coverage issues, missing information, or inability to read/understand
5. Communicates with facility and Third-party providers to get necessary coverage, missing information etc. to correct order to be processed
6. Input of medication orders with correct medication and frequency
7. Ensures formulary substitutions are made appropriately based on facility and third-party provider contracts
8. Completes appropriate paperwork/forms, as well as communicating order exceptions and any other discrepancies to facilities, third party providers, and team leaders
9. Transmit all third party and Medicaid online claims at time of order entry to ensure payment as well as dispensing fee.
10. Documents all admits/readmits processed on the admission log
III. General Office (5%)
- Attends training as provided for self-improvement and quality of work
- Accepts other duties as assigned
KNOWLEDGE, SKILLS, AND ABILITIES:
- Demonstrate superior customer service skills
- Ability to interact with all levels of department representatives both internally and externally
- Ability to exhibit effective verbal and written communication skills
- Maintains high level of attendance and punctuality
- Communicates in a positive and respectful manner with customers and internal team members
- Generates and supports ideas to improve service to internal and external customers
- Resolves conflict in a positive manner
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