Full Time; Monday - Friday; 8:00am - 5:00pm

Receives and processes prescription referrals received by the Specialty Pharmacy including data entry, insurance

processing, and prior authorization completion for specialty medications. Understands pharmacy benefit and medical

benefit claims submission process for reimbursement of prescription medications. Communicates with

patients/caregivers, insurance company representatives, and other members of the healthcare team for patients to

initiate and continue therapy.

At UnityPoint Health, you matter. We’re proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row for our commitment to our team members.  

Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in.  Here are just a few:      

• Expect paid time off, parental leave, 401K matching and an employee recognition program.   

• Dental and health insurance, paid holidays, short and long-term disability and more. We even offer pet insurance for your four-legged family members.  

• Early access to earned wages with Daily Pay, tuition reimbursement to help further your career and adoption assistance to help you grow your family.   

With a collective goal to champion a culture of belonging where everyone feels valued and respected, we honor the ways people are unique and embrace what brings us together.   

And, we believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience. 

Find a fulfilling career and make a difference with UnityPoint Health.

• Looks at the individual needs of each patient/customer and matches those needs to the many services UnityPoint at Home has to offer; utilizes other members of the home care coordination team as necessary to coordinate services outside of the specialized service line.
• Processes all incoming prescription orders; obtains demographic, financial, and other qualifying data to verify benefits and obtain authorization for specialty medications.
• Processes test claims of health system’s specialty pharmacy prescriptions through pharmacy dispensing software to determine available pharmacy options through patient insurance plans.
• Communicates/coordinates with patients/caregivers and members of the healthcare team appropriate actions based on patients’ benefits.
• Specializes in specialty pharmacy service line yet is responsible for having a basic knowledge of all service lines.
• Initiates and coordinates prior authorization requests to third party payers and maintains a working knowledge of third-party payer guidelines. Follows up with third party payers as necessary.
• Collects insurance information, runs test claims, obtains medical records as required for completion of prior authorizations.
• Re-verifies eligibility and benefits when patient starts a new benefit year. 90%
• Provides customer service to patients and physicians’ offices and coordinates the delivery of medications with patients/caregivers and/or members of the healthcare team via inbound and outbound calls, email, and other electronic messaging. · Operates pharmacy dispensing software and health system electronic health record to record, document, and retrieve pertinent medical information within the patients’ electronic medical record to ensure appropriate agency services are provided in a timely manner. · Establishes and maintains positive working relationships with current and potential providers and referral sources. · Upholds expectations and perceptions of UPAH as a high-quality provider of services by maintaining excellent customer service. · Maintains a working knowledge of relevant regulations affecting patients and the operation of our business. · Performs patient follow up phone calls as directed by manager or supervisor. · On-call duties may be required on a rotation basis, including weekends and holidays. · Prohibited from conducting evaluations or interpreting any clinical decision. Refers clinical questions to appropriate staff.

Education:

High school diploma or equivalent

Experience:

One year of medical experience; preferably in community home health or pharmacy

License(s)/Certification(s):

Nationally certified pharmacy technician registered with the Iowa Board of Pharmacy as a Certified Pharmacy Technician (or registered as technician trainee if not yet certified)

Registered Pharmacy Support

Valid driver’s license when driving any vehicle for work-related reasons