Pharmacy Tech/Biller

Kaweah Health is a publicly owned, community healthcare organization that provides comprehensive health services to the greater Visalia area in central California. With more than 5,000 employees, Kaweah Health provides state-of-the-art medicine and high-quality preventive services in our acute care hospital, specialized health centers and clinics. Our eight-campus healthcare district has 613 beds and offers comprehensive health services across a broad continuum of care. It takes a special person to work for Kaweah Health. We serve a region where the needs are great, which makes the rewards even greater. Every day, we care for people facing unique challenges and in need of healing. Throughout it all, our focus is to make a difference, and we do — in the health of our patients, our loved ones, and our community. Benefits Eligible Full-Time Benefit Eligible Work Shift Day - 10 Hour Shift (United States of America) Department 9553 Pharmacy-Retail Under the direct supervision of the Pharmacist, the Pharmacy Technician will perform assigned tasks, within their scope, necessary for the operation of the pharmacy. QUALIFICATIONS License /Certification Required: Pharmacy Technician registration with the California State Board of Pharmacy Preferred: Certification as a Pharmacy Technician Education Preferred: High school diploma or equivalent Experience Preferred: One year pharmacy technician experience JOB RESPONSIBILITIES Essential Keeps the pharmacy organized and clean. Maintains a friendly service-based attitude and work environment. Constantly strives to improve processes, productivity and quality. Keeps other staff apprised and informed, assists in training and mentoring. Keeps the Outpatient Pharmacy Manager informed of any potential issues or areas of concern on an ongoing basis. Answers telephone with courtesy. Takes messages as required and refers technical/clinical problems to the Pharmacist as appropriate or required by law. Participates in Pharmacy staff meetings, training, and ongoing education. Self-reports medication errors. Addendum (essential for specific dept) HOME INFUSION/PATIENT FINANCIAL SERVICES: Maintains knowledge of compounds and medications given by the pharmacy. Maintains knowledge of KDHIP, CHC (SNF Medi-cal billing) and Medicare Part D billing. Establishes and maintains patient charts, documentation, logs and files. Inputs information into computer, generates and uses reports to ensure smooth workflow of the pharmacy billing. Obtains TARs and SARs for billing the Medi-cal and CCS payers. Generates bills from computer system to bill payers. Maintains complete and full knowledge of payer(s) assigned to ensure compliance of specific guidelines and rules, as well as ensuring Kaweah Health is being reimbursed by the payer in accordance with governmental or contract terms. Acts as a resource to Finance division management regarding the assigned payer. Brings any reimbursement or compliance concerns to the attention of the Manager. Utilizes computer systems and/or billing reports to review all patient registrations or admissions for demographic information, appropriate financial class, insurance company and plan and charges. 100% accuracy of this information is required to ensure proper recording of revenue, necessary authorizations are obtained, payer classification, correct billing of patient accounts and other statistical indicators. Brings any unresolved issues to the attention of their manager. Audits unbilled reports for potential holdups of patient accounts. Works closely with pharmacy staff on DIF issues, insurance authorizations and documentation needed for billing. Completes billing process. Ensures all charges are accurate and appropriate. Payer guidelines will be followed during the billing process. After billing has been completed, follows up in a timely manner with appropriate payers to ensure payments will be received. Reviews and researches patient account credits and refunds as appropriate to patient and/or payer. Receives all correspondence and inquiries related to patient accounts and payer contracts for which they are responsible. Answers mail and takes appropriate action within specified timeframe. Bills any secondary payers, changes insurance plans or financial class accordingly and sends appropriate information to the secondary payer for co-pays, deductibles or denied services. Reviews and works aging reports to identify any unpaid accounts. Works to ensure that days in accounts receivable are met, maintained and/or lowered. Maintains job productivity and quality standards on a consistent basis as established by division management. Answers telephone with courtesy, takes messages as required, and refers technical/clinical problems to the Clinical Pharmacist as appropriate or required by law. Performs intake of patient to Home Infusion services. Validates insurance and obtains insurance authorization when required initially and ongoing. Informs patients of financial responsibilities prior to providing Home Infusion services. Coordinates initial and ongoing services with physician, nursing services, pharmacy services and patients. Coordinates and provides documents and information to Patient Accounting services for billing and authorizations. Works with Pharmacists to maintain current census. Assists the Pharmacist in providing effective, appropriate, and safe pharmacy services. Recognizes situations that exceed technician authority (e.g. drug information, pharmacist checks, etc.) and refers to pharmacist for follow-up and resolution. Always obtains pharmacist verification prior to dispensing medications to customers. Assists customers and keeps them apprised in processing prescriptions, billing, sales, pick-ups, mail outs, and payment collection if necessary. EMPLOYEE AND RETAIL PHARMACY: Assists the pharmacist in preparation of prescriptions within the scope allowed by California State Board of Pharmacy, Federal Law, and Kaweah Health Policies. Processes prescriptions through the Pharmacy Information System. Appropriately submits claims to insurance/payers. Contacts and follows up to physician offices for refill request and inquires. Maintains the database for the Information System including addition of new medications, pricing updates, physician database, back-ups, software updates, etc. End of day processing under the supervision of the Pharmacist-in-Charge (PIC) and Outpatient Pharmacy Manager. Provides reporting and audits when requested. Consistently documents refrigerator temperatures as part of established pharmacy policies and procedures. Assists the PIC in control substances perpetual inventories and CURES reporting. Maintains records, logs and prescriptions as mandated by State and Federal Laws and Regulations and Kaweah Health Policy under the supervision of the PIC. Responsible for deposits of monies/checks to Patient Financial Services per Kaweah Health policy. Responsible for end of day and end of month reconciliation of funds with the Point of Sales (POS) systems in use at the Pharmacy, including all types of payments. Under the supervision of the PIC, helps manage inventory and returns. Acts upon recall notices immediately. Orders pharmaceuticals for dispensing and pharmacy supplies. Orders contracted items and utilizes cost effective generic medications when applicable. Removes outdating unusable medications for return or disposal. Performs annual physical inventory per Kaweah Health policy. Assures medication stock is rotated when new orders are received and placed on the shelf. Assists the pharmacist in providing effective, appropriate, and safe pharmacy services. Recognizes situations that exceed technician authority (e.g. drug information, pharmacist checks, etc.) and refers to pharmacist for follow-up and resolution. Always obtains pharmacist verification prior to dispensing medications to customers Assists customers and keeps them apprised in processing prescriptions, billing, sales, pick-ups, mail outs, and payment collection if necessary. Performs pharmacy deliveries as part of the meds-to-beds program. Pharmacy deliveries will be for patient specific discharge medications from a Kaweah Health outpatient pharmacy. Pharmacy personnel may access unit specific medication rooms for medication deliveries when acting in this capacity and in accordance with Kaweah Health and department policies. Additional Demonstrates the knowledge and skills necessary to provide care and services appropriate to the population served on the assigned unit or work area. Performs other duties as assigned. Pay Range $22.48 -$33.72 If you want to use your talents alongside people who face each day with courage and purpose, in an environment that empowers you to do your absolute best, this is where you belong. Keep growing your career! Kaweah Health is committed to a culture that delivers personal, professional, and compassionate experiences for every person, every time. Explore our currently open positions and apply to the ones that fit you best. Keep track of your application in the selection process and new opportunities as they open. We hope you choose to join our team of dedicated professionals serving those who entrust us with their care. Not finding the right fit? Let us know you're interested in a future opportunity by clicking Get Started below or create an account by clicking 'Sign In' at the top of the page to set up email alerts as new job postings become available that meet your interest!