Stony Brook University Pharmacy Clerical Specialist in Commack, New York
Pharmacy Clerical Specialist
Required Qualifications: (As evidenced by an attached resume)
Associate’s degree (or foreign equivalent or higher) or in lieu of degree, two (2) years full time clerical or pharmaceutical experience. Four (4) years of full time clerical office, medical support experience in a medical office, pharmacy or a health care facility. Knowledge of pharmacy sig codes. Working knowledge of Electronic Medical Record (EMR). Knowledge of medical terminology. Proficient with MS Word and Excel.
Pharmacy technician including retail experience or LPN with pharmacy experience. Experience with documenting in Cerner EMR. Experience with a pharmaceutical delivery scheduling system. Experience liaising with third part pharmaceutical benefit companies. Knowledge of HIPAA rules and regulations. Familiarity with the World Trade Center Health Program (WTCHP).
Brief Description of Duties:
The successful candidate will be detail orientated requiring excellent organizational and communication skills and the ability to multi-task. The candidate should have a strong sense of responsibility and initiative, use sound judgement in making decisions and have the ability to work independently with minimal supervision. The Pharmacy Clerical Specialist will be responsible for the following duties:
Address incoming patient calls regarding their pharmacy prescription requests and prescription questions in a timely and professional manner. Communicate with members/patients regarding their pharmacy requests and educate on pharmacy benefits and document these interactions with members in EMR.
Manage and maintain prescription requests for patients in the WTCHP: Ensure prescription requests are authorized by the provider; Enter electronic prescription in the pharmacy delivery scheduling system (RXNT); Review and process all pharmacy and mail-order service prescriptions requests in VitalPoint, the pharmacy benefit manager website.
Assist Clinical Pharmacists with appropriate tasks.
Assist with monthly audits.
Mail and tracking certified letters.
Fax communications to providers.
Reach out to patients for clinical services.
Research to determine if a provider should be approved or denied, including: checking to see if the provider is in network, adding them if appropriate and checking to see if we referred the patient to the provider in question.
Review medications pending in VitalPoint (the pharmacy benefits manager website). Submit an approval decision based on whether the patient is certified for the medication, the provider is in network in the WTCHP and the medical rationale and letter of medical necessity is on file for the medication in question.
Organize pharmacy medications types regarding brand/generic utilization statics and inclusion in the monthly Quality Assurance (QA) reports provided to the National Institute of Occupational Safety and Health (NIOSH); Input drug exclusion (block medications) in patients profiles via Vital Point based on the findings by each provider from the QA reports.
Communicate the process of prior authorizations (e.g., requirements, expectations) to both patients and providers.
Track and process prior authorizations: Notify providers of existing drug prior authorization and their category (level 2 or level 3) required for the patients medications based on patient certification; Receive forms for Prior Authorizations and process overrides once approved so that patients can acquire their medications; Notify patients of denied Prior Authorizations; Scan approved and denied Prior Authorizations into the shared drive.
Communicate directly with Retail/Mail Order pharmacists and Vital Point personnel as needed regarding other overrides for patient’s medication
Assist with resolving billing issues encountered at pharmacies and mail-order service and when allowable, assist in getting reimbursed for pharmacy billing errors
Participate in the pharmacy benefits manager (PBM) monthly training and review PBM update e-mails
Other duties as assigned, including back-up of DME Clerical Specialist.
The Research Foundation of SUNY is a private educational corporation. Employment is subject to the Research Foundation policies and procedures, sponsor guidelines and the availability of funding. FLSA Nonexempt position, eligible for the overtime provisions of the FLSA.
This position is located in our Commack facility.
Stony Brook University is 100% tobacco-free as of January 1, 2016. See our policy and learn more atstonybrook.edu/tobaccofree.
About Stony Brook:
Long Island’s premier academic medical center, Stony Brook Medicine represents Stony Brook University’s entire medical enterprise and integrates all of Stony Brook’s health-related initiatives: education, research and patient care. It encompasses Stony Brook University Hospital, Stony Brook Children’s Hospital, the six Health Sciences schools — Dental Medicine, Health Technology and Management, Pharmaceutical Sciences, Medicine, Nursing and Social Welfare — as well as the major centers and institutes, programs and more than 50 community-based healthcare settings throughout Suffolk County. With 603 beds, Stony Brook University Hospital serves as Suffolk County’s only tertiary care center and Regional Trauma Center. Stony Brook Children’s, with more than 180 pediatric specialists in 30 specialties, offers the most advanced pediatric specialty care in the region.
Equal Opportunity Employer, females, minorities, disabled, veterans.
If you need a disability related accommodation, please call the University Human Resource Services Department at (631) 632- 6161 or the University Hospital Human Resources Department at (631) 444-4700. In accordance with the Title II Crime Awareness and Security Act, a copy of our crime statistics is available upon request by calling (631) 632- 6350. It can also be viewed on line at the University Police website at http://www.stonybrook.edu/police .
Job Field: Clerical/Secretarial
Primary Location: US-NY-Commack
Official Job Title: Clerical Specialist II
Department/Hiring Area: Medicine - WTCHP
The Research Foundation for The State University of New York at Stony Brook
Pass Days: Day Shift
Posting Start Date: Aug 8, 2018
Posting End Date: Aug 22, 2018, 10:59:00 PM
Salary: $38,000-$45,000 / Annual @ 1.0 FTE CWE
Salary Grade: N7
Req ID: 1802064