Workplace and Safety Orientation
Learn and employ Standard Operating Procedures (SOPs) particular to each technician role.
Take any relevant cultural sensitivity/awareness training.
Ensure patient confidentiality by learning, understanding, and applying the rules of the Health Insurance Portability and Accountability Act (HIPAA).
Work safely around equipment, materials, and co-workers.
Acquire familiarity with basics of Section 503 of Food, Drug, and Cosmetic Act.
Become familiar with and use Customer Relationship Management (CRM) Databases, such as PrimerX.
Data Entry/Order Origination: Claims Processing Technician
Receive prescriptions electronically and enter data into CRM databases.
Troubleshoot errors in demographic information by contacting patient and/or physician.
Identify prescriptions containing controlled substances and direct to insurance verification team (advanced claim processing) for processing.
Learn and employ 5 methods of originating: New to bill / No insurance information / Refills / Futures / Switches.
Prescription Claim Processing: Claims Processing Technician
Learn details of various insurance plans.
Research, locate, and navigate individual formularies.
Become familiar with different kinds of rejections.
Understand patient’s eligibility and plan requirements.
Gather documentation in effort to obtain coverage for patients.
Act as liaison between insurance, physician, and patient.
Advanced Claim Processing: Claims Processing Technician
Obtain prior authorization through multi-step process, including but not limited to:
Step 1: identify criteria for insurance coverage
Step 2: get clinical data from physician(s)/office(s) and necessary supporting documentation (e.g., International Classification of Disease (ICD)- 10 Codes, previous treatment diagnosis, lab work, etc.)
Step 3: work with clinical team to prepare prior authorization forms
Step 4: obtain and submit signed forms
Step 5: follow up and liaise between physicians and plan sponsors
Step 6: communicate with patient throughout process
Step 7: complete process, whether denial or approval and subsequent claim processing
Basic Treatment Work and Telephone Use: Pharmacy Communications Technician
Establish a baseline, i.e., level of treatment to be administered, by soliciting responses to a battery of questions regarding drug interactions, contraindications, allergies; set treatment goals.
Price medication: compute on an individual basis based on quantity of ingredients, individual cost and volume of ingredients, effort level required to produce medication, and delivery requirements.
Monitoring Treatment: Pharmacy Communications Technician
Counsel with clinicians.
Encourage adherence to treatment plan.
Measure progress towards goal.
Work with clinical team to revise treatment plan (if necessary).
Advanced Treatment Work: Pharmacy Communications Technician
Establish a baseline for rare, more complicated disease states.
Work with clinical team to investigate and assess disenrollment.
Drug Material Selection: Laboratory Technician
Work with inventory to: locate and pull material, such as vehicle (e.g., lotion) for active and inactive ingredients / fill bins/carts with drugs; validate National Drug Code (NDC) from database.
Use database (e.g., CRM) to assist with pulling master formulations, ingredients, and equipment needed to manufacture medication.
Stage medication for pharmacist to weigh active ingredients.
Validate expired drugs and dispose per procedure.
Handle, maintain, and clean equipment per procedure (partial list of equipment in Appendix B).
Reducing Particle Size: Laboratory Technician
Prepare mixing and milling equipment for use.
Mill material per procedure, including compound pouring and particle size selection.
Clean equipment after use per SOP; follow discard procedures; maintain proper work uniform.
Packing, Containerization, and Shipping: Laboratory Technician
Package medications for shipping.
Handle hazardous preparations and packages per procedure, including but not limited to: dry ice, temperature validation, temperature indicator card packaging.
Notify patients of expected delivery and any anticipated delays. Track packages to confirm delivery.
Triage and Order Management: Laboratory Technician
Coordinate lab room workflow; assign order priority utilizing customer database; coordinate process flow for compounding production line.
Durable Medical Equipment: Pharmacy Medical Equipment Technician
Learn to operate a workflow management system; understand and explain an order’s “life cycle.”
Enter information into database(s) with patient profiles.
Collect necessary documentation and ready for submission.
Handle basic inquiries, including delivery dates and equipment specifications.