Review and interpret physician medication orders to ensure appropriate therapies and enter prescription data in preparation for Pharmacist verification. Attention to accuracy, regulatory compliance, and efficiency are critical to patient safety and care, working within the limits of standard or accepted practice in a fast-paced Specialty Pharmacy.
Perform job assignments in full compliance and complete understanding of the State and Federal laws and internal policies and procedures governing the handling, dispensing and distribution of controlled substances.
Receive and stock inventory of medications in keeping with inventory storage organization system and regulatory and policy requirements. Contribute to periodic inventory process, counting, and recording drugs and supplies on hand.
Select drugs from stock, count, package and accurately label prescriptions for Pharmacist verification and shipment.
Provide administrative Pharmacy support as assigned and assist in the training of new associates in the Pharmacy.
Communicating with all new patients informing them of prescription referral and welcoming them to Kroger Specialty Pharmacy (KSP).
Respond to inbound Pharmacy calls, demonstrating customer service excellence, and triage to appropriate clinician or department. Communicate with patients, prescribers’ offices, and associates with a focus on building and maintaining enduring business relationships to the benefit of the organization and its customers.
Obtain patient’s medication drug list for DUR investigation.
Adjudicating and reviewing prescription insurance claims of medications to be delivered to patients and providers.
Contact insurance companies or other payers to complete prior authorization requirements, identify co-pay structure, and investigate coverage and benefits.
Provide information and respond to requests to assist to obtain co-pay cards or financial assistance for patients as applicable and indicated in information provided.
Perform or assist with any operations, as required to maintain workflow and to meet schedules and quality requirements.
Participate in any variety of meetings and work groups to integrate activities, communicate issues, obtain approvals, resolve problems and maintain specified level of knowledge pertaining to new developments, requirements, and policies.
Perform other related duties as assigned.
Qualifications and Requirements:
Consistent focus and attention to detail resulting in superior accuracy.
Exemplary communication skills, customer service, and customer relationship building skills; including listening, speaking, and writing.
Demonstrated organizational skills.
Clear and consistently demonstrated understanding of healthcare protocols for privacy.
Demonstrated proficiency with pharmacy applications and in operating computer with knowledge of office software including MS Word and Excel (CPR+ and/or QS-1 preferred).
May require demonstrated knowledge of medications utilized for therapy in the defined disease states served by the assigned pharmacy.
High School Diploma or equivalent, plus additional specialized training in pharmacy/medical benefit access and requirements.
Minimum 1 year’ experience in healthcare customer service with knowledge of benefits access processes highly preferred.
Some jurisdictions where this role is performed may require that associates maintain endorsement as a Certified Pharmacy Technician and report through a Pharmacist Manager, in addition to the above requirements.