Pharmacy Technician - Specialty Call Center

Join the Cleveland Clinic team where you will work alongside passionate caregivers and provide patient-first healthcare. Here, you will receive endless support and appreciation while building a rewarding career with one of the most respected healthcare organizations in the world.   

As a Pharmacy Technician in the Specialty Call Center, a caregiver in this role will help patients access specialty medications by coordinating prescription processing, insurance benefits and financial assistance. Responsibilities include processing insurance claims, conducting initial benefits investigations, assisting with copay assistance programs and reviewing patient charts for medication changes that may affect prior authorization requirements. The caregiver will also enter prescriptions into the computer system and manage a steady volume of incoming phone calls while balancing daily responsibilities. Working closely with pharmacists, insurance companies, fellow pharmacy technicians, the benefits department and patients, the caregiver will help support timely medication access and a positive patient experience.

A caregiver who excels in this role will:  

• Initiate prior authorizations and communicate with third party payers on behalf of the physician and patient.  

• Find and apply manufacturer co-pay cards and initiate patient assistance and co-pay assistance applications.  

• Reach out to patients to manage refills and schedule necessary current and future assessments. 

• Ensure the accuracy of prescription and patient data entered various systems by verifying patient, drug, quantities, directions, day’s supply, insurance and physician data. 

• Conduct a thorough benefits investigation and process any necessary prior authorizations and/or appeals for pharmacy claims. 

• Explain benefit coverage and financial responsibilities to the patients.   

• Supply financial assistance contact information and/or initiate patient assistance and copay assistance applications on behalf of the patients.  

• Resolve aspects of specialty pharmacy insurances, including Medicare, Medicaid, Pharmacy Benefit Managers (PBM) and Preferred Provider Organizations (PPO) and communicate with payors and advise patients or physicians of results as needed.   

• Utilize all pharmacy systems to review patient profiles, enter changes and establish assessment schedules. 

• Document all patient/client/provider contact in appropriate computer systems. 

Minimum qualifications for the ideal future caregiver include:  

• High School Diploma/GED   

• Upon hire, you must be a Certified Pharmacy Technician (CPhT) through the Pharmacy Technician Certification Board (PTCB) or the National Healthcare Association (NHA).  

• In addition to the above requirement, upon hire, it is required to hold an active registration through the Ohio Board of Pharmacy (OBOP) as either a Certified Pharmacy Technician, Registered Pharmacy Technician, or Pharmacy Technician Trainee   

• Please note: Caregivers with active Pharmacy Technician Trainee or Registered Pharmacy Technician registrations are required to update their registration to a Certified Pharmacy Technician registration with the OBOP within 6 months  

Preferred qualifications for the ideal future caregiver include:  

• Certified Pharmacy Technician with PTCB and NHA
• Retail experience
• Experience with billing and insurance
• Prior Authorization

• Typical physical demands include ability to perform the job while standing, reaching, stretching, stooping, and sitting for prolonged times.
• Manual dexterity sufficient to perform computer and dispensing functions of the job.
• Ability to lift up to 20pounds while walking, stooping, bending and reaching.

• Follows standard precautions using personal protective equipment as required.

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our drug free environment. All offers of employment are followed by testing for controlled substances.

Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption.

Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility. 

If applying for a Florida position, please see the following website for more information on the background screening requirements required by the Agency of Health Care Administration: https://info.flclearinghouse.com/

Please review the Equal Employment Opportunity poster. 

Cleveland Clinic is pleased to be an equal employment opportunity employer.