Arbiter/Failed Claims Technician

About the role

Under the direct supervision of the Pharmacy Supervisor (FL), update prescription orders following all pharmacy procedures and guidelines.

Responsibilities

• Perform routine, professional pharmacy functions.
• Respect and maintain confidentiality guidelines of HIPAA.
• Follow and aid in enforcement of all company policies and procedures.
• Answer all emails in the arbiter email box in a timely and accurate manner.
• Responsible for orders in failed claims and high co-pay queue.
• Ensure insurance information is accurate for correct adjudication.
• Accountable for checking patient history for refill too soon, increase/decrease of dose, and duplicate scripts.
• Ensure all prior authorizations are started in a timely and accurate manner.
• Responsible for other duties as assigned.

Requirements

• High School Diploma or equivalent
• Registered Pharmacy Technician with the State of Florida
• Preferred – national certification (CPhT)
• One year minimum of pharmacy experience
• Knowledge of health insurance plans
• Familiarity with Microsoft Word, Excel, and Outlook

Skills

• Attention to detail
• Ability to handle multiple activities or interruptions at once
• Ability to communicate effectively, patiently and courteously
• Focused team player, who can work in conjunction with pharmacists, other departments, customers, and management
• Work independently with little supervision and meet daily deadlines
• Ability to perform repetitious work accurately

Work Environment

This position is in a typical office environment which requires prolonged sitting and standing in front of a computer. In addition, this position requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment, including the operation of standard computer and phone equipment. May have occasional high stress when dealing with customers/clients and employees. This position may be required to work long hours.