Prior Authorization Technician - Pharmacy Technician

4 months, 2 weeks ago
Junior
Customer and Technical Support
Shields Health Solutions

Shields Health Solutions

Shields Health Solutions is the first and largest company in the nation to integrate specialty pharmacies within hospitals, focusing on improving patient outcomes and system-wide growth. Their programs and data platforms reduce costs, achieve better cl...

Health Care Providers & Services
1K-5K
Founded 2012

Description

  • Directly communicate with insurance companies to facilitate medication approvals.
  • Navigate pharmacy operating systems to enter data, adjudicate test claims, and prepare follow-up action plans.
  • Document patient concerns, prior authorization status, and financial assistance needs across databases, electronic medical records, and email.
  • Review prescriptions with doctors' offices to support optimal patient care.
  • Maintain complete and accurate records of patient communications.
  • Assist patients with managing pharmacy insurance claims.
  • Work closely with pharmacists and pharmacy liaisons to support integrated patient care.
  • Communicate with patients by phone to support medication compliance and refill needs.
  • Research and investigate information to support decision-making and operational improvements.
  • Manage, organize, and update relevant data using database applications.
  • Identify trends, resolve problems, recommend improvements, and help implement process changes.
  • Protect confidential information and participate in ongoing educational opportunities.

Requirements

  • High school diploma or GED required.
  • 1+ years of experience as a Pharmacy Technician required.
  • State registered or state certified pharmacy technician required.
  • National certification as a CPhT or equivalent strongly preferred.
  • If no state registration is available in the candidate's state, national certification is required at time of hire.
  • If additional licensure is needed, the candidate must obtain it within a mutually agreed timeframe.
  • Minimal in-state or out-of-state travel may be required.

Interested in this position?

Apply directly on the company website

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