Pharmacy Services Technician

Cambia Health Solutions

Tacoma, WA

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JOB DETAILS

JOB TYPE

Full-time, Employee

SKILLS

Artificial Intelligence (AI), Billing, Biotech and Pharmaceutical, Business Practices, Calculators, Certified Case Manager (CCM), Certified Pharmacy Technician (CPhT), Chemotherapy, Consulting, Current Procedural Terminology (CPT), Customer Support/Service, Documentation, Establish Priorities, Fax Machines, Formulary, Government, HIPAA (Health Insurance Portability and Accountability Act), Health Economics, Health Insurance, Healthcare, Healthcare Common Procedure Coding System (HCPCS), High School Diploma, Hospital, ICD-10, Medical Assistance, Medical Coding, Medical Terminology, Medications, Microsoft Excel, Microsoft Word, Nursing, Operations Processes, Patient Charts, Pharmacy, Regulations, Reimbursement, Retail, Systems Maintenance, Team Player, Technical Support, Time Management, Work From Home

ADDITIONAL COMPENSATION

n/a

LOCATION

Tacoma, WA

POSTED

30+ days ago

Pharmacy Services Technician

Work from home Within Oregon, Washington, Idaho or Utah

Build a career with purpose. Join our Cause to create a person-focused and economically sustainable health care system.

Who We Are Looking For:

Every day, Cambia's dedicated Pharmacy Services Technician, are living our mission to make health care easier and lives better. As a member of the Pharmacy Operations team, our Pharmacy Services Technician is a corporate-wide technical support resource for pharmacy benefit, reimbursement, and other drug use issues which do not require clinical judgment. This function assists the Clinical Pharmacy Consultants and Pharmacy Services staff with formulary-related operations and other operational processes which require knowledge and experience with pharmaceuticals, all in service of creating a person-focused health care experience.

Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit.

What You Bring to Cambia:

Qualifications:

* High school diploma or related certificate required
* Three years of experience as a pharmacy services technician in a retail, hospital, or other licensed pharmacy setting, or equivalent combination of education and experience
* Pharmacy Technician certificate may be substituted for two years of experience

Skills and Attributes:

* Knowledge of medical terminology, health care coding systems such as ICD-10, CPT and HCPCS, and HIPAA regulations, along with knowledge of pharmaceutical products including orals, injectables, infusion products, and chemotherapy
* Knowledge of general office practices and procedures with demonstrated knowledge of grammar and techniques of business practice
* Ability to interact effectively with a variety of health care professionals including physicians, nurses, pharmacists, and billing staff both internally and externally, while demonstrating maturity, tact, diplomacy, and persuasiveness
* Demonstrated ability to perform pharmaceutical dosing calculations and operate a variety of standard business machines including calculators and faxes
* Ability to type 30 words per minute (60 wpm preferred) with basic computer program skills including Word, Excel, and other standard applications
* Ability to organize, plan, and prioritize daily workflow and projects within time constraints; experience with health insurance and/or prescription benefits preferred
* Experience with AI tools and technologies to enhance productivity and decision-making in professional settings highly desired

What You Will Do at Cambia:

* Perform all duties as described unless clinical judgment is required, in which case seek assistance from appropriate medical personnel who will be available for support during normal business hours
* Respond to non-clinical pharmacy issues from providers, pharmacy services staff, case managers, preauthorization nurses, ENCC personnel, government programs personnel, and customer service regarding formulary drug coverage, appeal and reconsideration claim status
* Complete daily formulary operational processes including tracking, processing, and obtaining appropriate documentation for pharmacy medical exception requests, prior authorization requests, reconsiderations, and appeals
* Prepare reconsideration requests for Clinical Pharmacy Consultant review by obtaining and organizing appropriate documentation including medical chart notes, reports, and medication profiles; communicate information and determinations to providers and members orally and through written documentation as necessary
* Obtain and organize drug utilization data including patient-specific and population-based data in a manner that facilitates clinical review and decisions
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About the Company

Cambia Health Solutions

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