Prior Authorization Technician – Pharmacy Technician

Role Overview

• Provide patient care by removing the barriers to medication access
• Work with insurance companies and clinician offices to facilitate approval of medications through prior authorizations
• Provide phone support to patients by navigating pharmacy dispensing systems to adjudicate claims, refill medications, and increase adherence in patients
• Directly communicate with insurance companies to facilitate the approval of medications
• Navigate pharmacy operating systems to input data, perform adjudication on test claims and prepare action plans for follow-up
• Effectively communicate across databases, electronic medical records and emails to document patient concerns, prior authorization status, and financial assistance needs
• Review prescriptions with doctors' offices to ensure optimal care of the patient
• Keep complete and accurate records of patient communications
• Assist patients in the management of their pharmacy insurance claims
• Work closely with pharmacists and pharmacy liaisons to provide an integrated approach quality patient care
• Communicate directly with patients over the phone to assist them in all aspects of medication compliance
• Research and investigate information to enable strategic decision-making by others
• Manage, organize, and update relevant data using database applications
• Apply observations and recommendations to operational issues, increased productivity, quality, and customer-service standards
• Identify trends, resolve problems; recommend improvements; implement change
• Actively participate in process improvement initiatives
• Act as a value-added business partner to stakeholders throughout the organization
• Protect organization's value by keeping information confidential
• Update job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations
• Minimal in or out of state travel may be required
• Perform other duties as assigned

Requirements

• 1+ years as a Pharmacy Technician
• State registered or state certified as a pharmacy technician
• Nationally certified as a CPhT or equivalent is strongly preferred but not required
• High school diploma or GED required

Benefits

• Health insurance
• Flexible work hours
• Professional development opportunities