Pharmacy Technician

At EVERSANA, we are proud to be certified as a Great Place to Work across the globe. We’re fueled by our vision to create a healthier world. How? Our global team of more than 7,000 employees is committed to creating and delivering next-generation commercialization services to the life sciences industry. We are grounded in our cultural beliefs and serve more than 650 clients ranging from innovative biotech start-ups to established pharmaceutical companies. Our products, services and solutions help bring innovative therapies to market and support the patients who depend on them. Our jobs, skills and talents are unique, but together we make an impact every day. Join us!

Across our growing organization, we embrace diversity in backgrounds and experiences. Improving patient lives around the world is a priority, and we need people from all backgrounds and swaths of life to help build the future of the healthcare and the life sciences industry. We believe our people make all the difference in cultivating an inclusive culture that embraces our cultural beliefs. We are deliberate and self-reflective about the kind of team and culture we are building. We look for team members that are not only strong in their own aptitudes but also who care deeply about EVERSANA, our people, clients and most importantly, the patients we serve. We are EVERSANA.

THE POSITION

The Program Specialist II (PSII) works independently on routine and moderately complex cases and exercises judgment within established program guidelines. As the primary case-management and benefits verification specialist for assigned programs, the PSII manages patient enrollment activities, benefit investigations, insurance verification, and routine patient access issues while serving as a primary point of contact for patients, providers, and payers. Complex reimbursement, prior authorization, appeals, and escalation issues are referred to the Program Specialist III or next level leader.

The PSII delivers an exceptional patient and provider experience through inbound and outbound telephony support, document triage, follow-up on missing information, data entry, and patient benefit verification activities. The PSII ensures adherence to program business rules, company policies and procedures, and HIPAA guidelines.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Our employees are tasked with delivering excellent business results through the efforts of their teams. These results are achieved by the following actions:

Consistent with the Americans with Disabilities Act (ADA) and applicable state and local laws, it is the policy of EVERSANA to provide reasonable accommodation when requested by an employee with a disability, unless such accommodation would cause an undue hardship for EVERSANA. If reasonable accommodation is needed to perform the essential functions of your job position, please contact Human Resources.

EXPECTATIONS OF THE JOB

- Travel: 0%.
- Hours: 40 hours per week, 5 days per week.
- Serve as the primary point of contact for healthcare providers and inbound callers, obtaining complete patient enrollment and insurance information while utilizing critical and creative thinking to effectively resolve customer and work-related issues.
- Foster a collaborative, team-oriented approach in all interactions.
- Communicate effectively with others with clarity and transparency.
- Complete data entry tasks; enter and set up new patients in database; prescription processing.
- Complete manual and electronic patient benefit verifications.
- Recognize, assess, and appropriately escalate complex reimbursement or access-related issues.
- Achieve productivity, quality, attendance, and service-level performance metrics.
- Special project support as necessary.

The above list reflects the general details necessary to describe the expectations of the position and shall not be construed as the only expectations that may be assigned for the position.

An individual in this position must be able to successfully perform the expectations listed above.

MINIMUM KNOWLEDGE, SKILLS AND ABILITIES

The requirements listed below are representative of the experience, education, knowledge, skill and/or abilities required.

PHYSICAL/MENTAL DEMANDS AND WORKING ENVIRONMENT

The physical and mental requirements along with the work environment characteristics described here are representative of those that an individual encounters while performing the essential functions of this position.

While performing the essential functions of this job the employee is frequently required to reach, grasp, stand and/or sit for long periods of time (up to 90% of the shift), walk, talk and hear; occasionally required to lift and/or move up to 25 pounds. This job operates in a professional office and/or remote work environment. This role routinely uses standard office equipment. The noise level in the work environment is usually moderately quiet, with frequent interruptions and multiple demands.

This role requires mental alertness. The employee must regularly communicate both verbally and in writing; concentrate on tasks; and remember and observe details. The employee must frequently adjust to changes; handle stress and emotions; and think analytically.

Responsibilities

Process all incoming documents including uploading and processing data within the appropriate patient database(s).; Handle inbound and outbound calls and document interactions. Triage calls as necessary and route them appropriately, with the goal of achieving one touch caller resolution. Recognize issues requiring escalation in accordance with program guidelines.; Complete benefit investigations and eligibility assessments, research coverage requirements, out-of-pocket costs, and payer requirements to facilitate patient access to therapy.; Escalate complex reimbursement, appeals, and prior authorization issues to Program Specialist III or next level leader.; Coordinate with patients, providers, and payers to obtain missing information and resolve routine access barriers.; Independently manage patient cases from intake through benefit verification completion, ensuring accurate documentation, timely follow-up, and adherence to program requirements.; Maintain the confidentiality and integrity of protected health information, follows HIPAA security policies and procedures.; Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.; All other duties as assigned.

Requirements

Education : High School Diploma/GED.; Experience and/or Training :; One to two years of relevant experience in healthcare operations, benefit verification, or a related customer service role.; Accurate and detail-orientated.; Experience supporting customers, patients, providers or administrative processes in a pharmacy or healthcare setting.; Demonstrated data-entry and customer service capability.; Experience conducting benefit investigations, insurance verification, documentation review, program support, patient access support, or similar healthcare operations activities.; Working knowledge of medical and pharmacy benefit structures, payer types, and reimbursement processes.; Ability to effectively manage high-volume phone interactions while maintaining quality and customer service standards.; Technical/Equipment :; Advanced computer proficiency with strong data entry accuracy and productivity.; Proficient in Microsoft Word, Excel, Outlook, and PowerPoint, including the ability to create reports and analyze routine data.; Demonstrated experience utilizing patient support, case management, CRM, healthcare operations, and workflow management systems.; Ability to efficiently navigate multiple databases, applications, and electronic systems simultaneously.; Proficiency with telephony/call center technology and associated documentation tools.; Ability to accurately maintain electronic patient records and resolve routine data discrepancies.; Ability to troubleshoot basic system, workflow, and user issues within supported applications; Behavioral Competencies :; Reliability.; Independent judgment.; Customer Focus.; Critical thinking.; Issue resolution.; Prioritization.; Clear communication.; Soft Skills : Strong oral, written, and interpersonal communication skills, with the ability to explain program requirements clearly to patients, providers, and payers. Ability to multi-task and solve moderately complex problems using independent judgment. Ability to work independently, have personal accountability, and function as a collaborative team player. Ability to work in a fast-paced, metric-driven environment while remaining patient minded. Strong customer service skills. Adaptable, resilient, and aligned with EVERSANA's culture, values, and commitment to excellence; Licenses/Certificates : Ability to obtain a Missouri pharmacy technician registration. Note: This may not be required for all positions.

Nice to have

Education : Associate’s Degree.; Experience and/or Training:; Experience in a pharmacy or healthcare setting.; Customer service and/or call center experience.; Medical billing experience.