Pharmacy Technician

Position Title: Pharmacy Technician/Patient Access Specialist

Work Location: Cary NC 27513

Assignment Duration: 3 Months

Work Schedule: M-F

Work Arrangement: Onsite

Position Summary:

The Biologics Patient Access Specialist is responsible for supporting patients, providers, and internal teams by coordinating all aspects of access to specialty and biologic medications. This role ensures timely benefits investigations, prior authorization support, financial assistance navigation, and proactive communication to remove barriers and help patients start therapy as quickly and smoothly as possible.

Key Responsibilities:

1. Benefits Investigation & Coverage Verification
   * Conduct comprehensive benefit investigations for biologic and specialty therapies.
   * Verify insurance eligibility, coverage limitations, deductible/co-pay amounts, and specialty pharmacy requirements.
   * Identify prior authorization, step therapy, quantity limit, or reauthorization needs.
2. Prior Authorization & Appeal Support
   * Gather clinical documentation required for prior authorization submissions.
   * Communicate PA criteria, required forms, and next steps to providers.
   * Track PA status closely and provide timely updates.
   * Assist with written or verbal appeals when coverage is denied.
3. Financial Assistance Coordination
   * Screen patients for co-pay assistance, foundation grants, or manufacturer-sponsored programs.
   * Help patients complete required paperwork and follow up on application status.
   * Work closely with internal and external stakeholders to ensure funding alignment with payer requirements.
4. Patient Communication & Support
   * Provide clear, compassionate communication about coverage status, delays, or next steps.
   * Educate patients on therapy onboarding, timelines, and support program resources.
   * Manage inbound and outbound calls with professionalism, accuracy, and empathy.
5. Provider & Pharmacy Coordination
   * Collaborate with provider offices to obtain missing documentation, signatures, or clinical details.
   * Communicate with specialty pharmacies regarding prescriptions, triage steps, and authorizations.
   * Ensure complete, accurate information flows between all parties to avoid delays.
6. Documentation & Compliance
   * Maintain detailed, accurate progress notes in Caretend/AssistPoint or other system platforms.
   * Adhere to HIPAA guidelines and internal compliance standards.
   * Track and document all steps to support audits, URAC requirements, and internal QA expectations.
7. Workflow & Performance Expectations
   * Meet productivity and quality benchmarks, including:
   o Turnaround times for BVs and PAs
   o Quality audit standards
   o Call handling metrics (when applicable)
   * Support cross-functional teams as needed based on business workload and service level needs.