What we are looking for

Optime Care is seeking a Pharmacy Technician, or Care Coordinator, as we call them internally, for our Earth City, MO location. We are looking for someone passionate about helping people get the specialized therapies they need. This critical role serves as a patient's first or ongoing point of contact. They will act as the patient advocate and champion, guiding patients through obtaining pharmaceuticals unavailable at chain pharmacies.

This position will be required to be in the office 5 days a week, Monday through Friday.

What the position will be doing

Act as a patient advocate to gain insurance coverage for prescribed therapies
Welcome new patients and create profiles with all the critical information
Conduct periodic insurance verification and/or authorizations for patient coverage
File claims for patient prescriptions and orders
Complete collection activities per client program specifications
Provide an initial and ongoing investigation and benefit explanation to the patient
Obtain and maintain Prior Authorizations.
Create patient orders and associated prescription entries for new and refilled prescriptions
Communicate with prescribers, including requesting new prescriptions
Bill appropriate entities for RX drugs and administration supplies
Assist patients with possible financial assistance
Arrange all necessary documents and materials for initial and ongoing shipments
Coordinate all deliveries and process any patient returns.
Obtain necessary consent forms for manufacturers or patient support organizations
Assist pharmacists with day-to-day tasks such as filling prescriptions and entering prescription information into the patient management system for pharmacist verification
Assist in preparing any ad hoc report requests from clients.
Perform other related duties as assigned or as necessary; remains flexible and adaptable in work schedules and work assignments as defined by departmental and organization needs

Necessary Skills, Education & Abilities

A high school diploma or equivalent is required
2 or more years of experience with medical/pharmacy insurance verification, including benefit investigation
Current Missouri BOP Pharmacy Technician license, or Nurse license in good standing
Knowledge of medical terminology required.
Knowledge of medical/pharmacy insurance benefit language- ie. EOBs, deductibles, out-of-pocket, co-insurance, co-pays, etc
Ability to define CMS 1500s, provider numbers, CPT, HCPC’s, ICD9, NCPDP and NDC codes/numbers
Knowledge of Medicare and Medicaid billing
Patient Assistance Program knowledge is a plus
Experience with prior authorization and SMN preparation
Knowledge of insurance claim appeals
Relentless attention to detail, and the ability to be a creative self-starter and team player
Computer literate and proficient with Microsoft Office
Ability to participate in and facilitate group meetings.
Ability to thrive in a fast-paced environment with constantly changing and competing priorities
Excellent analytical skills and the ability to provide solutions to complex problems
Ability to be highly transparent, ethical, and driven.
Excellent written and verbal communication skills and interpersonal skills are required
Willingness to work a flexible schedule

About Us

Optime Care is a Specialty Pharmacy dedicated to providing services to smaller patient communities. We focus on securing insurance coverage, coordinating care, and complying with therapy regimens are only a few examples. Our mission is to minimize the daily impact of living with unique disorders. After just one call, our experts begin to address everything from medication delivery and insurance reimbursement to compliance and education. Every patient receives a proactive service experience tailored to their specific needs.

Optime Care provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

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Optime Care

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Pharmacy Technician - Specialty Pharmacy