Order Entry Tech

Data Entry of new and refill orders which includes:
1. Interprets prescription directions, including the clarification and communication to the facility when necessary
2. Identifies orders that cannot be processed due to coverage issues, missing information, or inability to read/understand
3. Inputs medication orders with correct medication and frequency. Minimum requirement is 30 orders per hour.
4. Ensures formulary substitutions are made appropriately based on facility contracts
5. Completes appropriate paperwork/forms, as well as communicating order exceptions and any other discrepancies to facilities and team leaders
6. Transmit all third party and Medicaid online claims at time of order entry to ensure payment as well as dispensing fee.
7. Maintains an understanding of the special requirements for each payer including Medicare/Managed Care/Medicaid Formulary and Non-Formulary/Third Party Insurance as well as communicate discrepancies to facilities regarding:
* Formularies
* Rejections
* Contract requirements
* Exclusions and Non-covered medications
8. Adherer to special Facility processing requirements (i.e. House Stock, Non-covered Medication Policies)
9. Researches and communicates with facility regarding any processing and reimbursement issues with order

Admission/Readmission of residents to Pharmacy System

Process new admission/readmission information for residents:

1. Reviews admissions and enters correct admission pay type information into Pharmacy system calling facility when pay type information not available
2. Collects information from facilities regarding resident insurance cards, social security number, guarantor demographics, room number, wing, allergies, diagnosis, verifies patient medication needs, etc.
3. Verifies Insurance/Medicaid eligibility
4. Identifies orders that cannot be processed due to coverage issues, missing information, or inability to read/understand
5. Communicates with facility and Third-party providers to get necessary coverage, missing information etc. to correct order to be processed
6. Input of medication orders with correct medication and frequency
7. Ensures formulary substitutions are made appropriately based on facility and third-party provider contracts
8. Completes appropriate paperwork/forms, as well as communicating order exceptions and any other discrepancies to facilities, third party providers, and team leaders
9. Transmit all third party and Medicaid online claims at time of order entry to ensure payment as well as dispensing fee.
10. Documents all admits/readmits processed on the admission log

General Office

* Attends training as provided for self-improvement and quality of work
* Accepts other duties as assigned