Central Prior Authorization Pharmacy Tech.- Remote Position

Apotheco, LLC•Short Hills, NJ

7h•Remote

About The Position

The Central Prior Authorization Pharmacy Technician will serve as the primary coordinator for specialty medication prior authorizations (PAs), ensuring timely processing and approval of specialty drug therapies. This role will work closely with prescribers, patients, insurance providers, specialty pharmacies and internal pharmacy teams to facilitate medication access, obtain required documentation, track authorization statuses, and support reimbursement process. This position requires strong organizational skills, attention to detail and knowledge of specialty pharmacy and insurance workflows. This position can be remote, home-based position requiring reliable internet access and a private workspace for confidential patient interactions. Must adhere to all company policies, procedures, confidentiality standards and security protocols applicable to remote employees.

Requirements

Pharmacy Technician Experience.
Knowledge of commercial, Medicare, and Medicaid insurance plans.
Familiar with the prescription adjudication process.
Ability to learn pharmacy management systems to extrapolate pertinent data.
Ability to communicate effectively within various levels of the organization.
Ability to read, comprehend, and write correspondence.
Need to be able to effectively present information in one-on-one and small group situations to all employees of the organization.
Ability to comprehend and apply principles of basic math.
Ability to apply common sense understanding.
Strong analytical and problem-solving skills.
Need to have excellent interpersonal, negotiation, and conflict resolution skills.
Proficient in Word and Excel. or related software;
Comfortable using RingCentral and experience with patient outreach;
Time management
Oral and written communication skills
Professionalism
Organization skills
Customer Service
Prioritizing skills
Detail-oriented
Multi-task abilities
Goal-oriented
Dependable
Confidentiality
Self-motivated
Ability to work well with various departments and within a team.
Participate in continuous quality improvement activities
Abide by Apotheco information security policies, employee handbook and security and privacy regulatory requirements.
Responsible for the secure and appropriate handling of Apotheco information, information received by customers, other companies and/or external parties.

Nice To Haves

Experience with specialty medications and prior authorization processes preferred.
Familiarity with specialty pharmacy workflows and reimbursement procedures.
Experience using payer portals such as CoverMyMeds or similar authorization platforms preferred.

Responsibilities

Manage and process prior authorization requests for specialty medications.
Communicate with provider offices, patients, payers and specialty pharmacies to obtain clinical documentation and authorization approvals.
Submit, monitor and track PA requests through payer portals, fax, phone and electronic systems.
Follow up on pending PAs, appeals, renewals, and denials to ensure timely patient access.
Verify patient insurance coverage, benefits, and specialty pharmacy requirements.
Input all necessary data into the pharmacy management system to track and maintain up-to-date project information.
Receive, analyze, gather, and organize data from multiple sources.
Accurately enter required data into one or more databases, documents, or spreadsheets.
Work closely with different functional departments including but not limited to pharmacy operations, sales, and data team.
Support all existing data projects.
Use pharmacy system to obtain patient and drug information and process prescriptions.
Manage prescription refills for integrated offices.
Apply manufacturer copay cards if applicable.