Pharmacy Technician - Prior Authorization Specialist II or III

Arizona Liver Health • Mesa, AZ

1d • $23 - $32 • Onsite

About The Position

The Pharmacy Technician - Prior Authorization Specialist II or III is a crucial part of the healthcare team to assist patients in providing specialized, complex medications for their liver disease and/or condition. This includes obtaining authorizations, navigating financial assistance options, and working with patients, payors, and pharmacies. The prior authorization specialist takes care of the prescription from the time it is ordered to ensuring the patient receives the medication(s).

Requirements

• At least one to two (1-2) years of experience working in Pharmacy Prior Authorizations required
• Prior experience and working knowledge with pharmacy operations
• Ability to work independently with minimal day-to-day supervision
• Excellent written, verbal, and interpersonal/patient-service communication skills required
• Proficient in Microsoft Office including Outlook and Excel
• Intermediate-level data entry computer skills with high attention to detail
• Ability to multi-task between different platforms, programs
• EMR or pharmacy software proficiency required
• Good working level knowledge of pharmacy insurance benefits required
• High school diploma or GED from an accredited institution required
• CPhT Certification (PTCB or NHA) and Arizona License in good standing preferred.
• Complete Apexus 340B on-line Modules upon hire
• Experience with all aspects of the day- to -day pharmacy operations
• Prior pharmacy benefits experience required.
• Must have valid documentation and authorization to work in the U.S.

Nice To Haves

• Previous lead-tech experience highly preferred
• Prior experience assisting in preparing detailed policy and procedures for accrediting agencies preferred
• Bilingual (English/Spanish) preferred
• Associate or bachelor’s degree in pharmaceutical or healthcare related field preferred

Responsibilities

• Assure all prior authorizations (PA) requirements are complete.
• Facilitate labs/immunization completion for patient payor compliance.
• Interact professionally with patients, peers, and other outside vendors as required.
• Assists in training new pharmacy staff along with level III PA Specialists on organizational processes and compliance procedures
• Manage pharmacy software for patient compliance with treatment.
• Supports comprehensive coordination of commercial, Medicaid and/or Medicare pharmacy services including intake and processing of pharmacy authorization requests.
• Promotes and supports quality effectiveness of healthcare and Pharmacy Services within clinical setting
• Evaluates, aids in authorizing approval, and communicates decisions for pharmacy requests according to clinic process
• Evaluates and aids in authorizing approval of pharmacy requests received by telephone, facsimile, and/or other means using client clinical criteria
• Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements with minimal supervision
• Process requests in compliance with various laws and CMS regulations and company policies and procedures
• May communicate with payors, external pharmacies, patients, case managers, electronic PA platforms
• Promotes communication, both internally and externally, to enhance effectiveness of medication therapy management services
• Escalates requests to Nurse Case Manager when request requires extensive clinical review or denial

Benefits

• Health, Dental, Vision (with HSA plans and employer contribution)
• 2 weeks PTO
• Continuing Medical Education budget (CME) and time off
• 5 days Sick Time
• 7 Company holidays and 2 half-days
• 401K with company match
• Short & Long Term Disability
• Shared company vehicles for required travel

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 101-250 employees