Prior Authorization Coordinator

Cencora•Reading, PA

3d•Hybrid

About The Position

The Prior Authorization Coordinator is a pharmacy technician who will act as onsite triage for identified patients and prescriptions, including specialty prescriptions, to facilitate authorization, reimbursement and dispensing of medications.

Requirements

Ability to communicate professionally and effectively both orally and in writing
Ability to work independently and as part of a team in a fast-paced environment.
Exceptional interpersonal and communication skills, with ability to effectively address patient issues and collaborate with healthcare providers.
Familiarity with pharmaceutical products, pharmaceutical terminology, and clinical pharmacy services
Strong organizational skills; attention to detail
Familiarity with prior authorization process and insurance verification.
Good analytical skills.
Commitment to maintaining patient confidentiality and privacy.
Experience in using pharmacy software systems and electronic health records.

Nice To Haves

Requires a minimum of two (2)+ years directly related and progressively responsible pharmacy experience; bachelor's degree program preferred.
Pharmacy technician certification with a national technical certification organization, such as Pharmacy Technician Certification Board (PTCB) or other comparable national certification or comparable state certification is preferred.

Responsibilities

Master navigation of EMR and dispensing software system.
Provide excellent customer service to patients and healthcare professionals by answering inquiries, addressing pharmacy-related concerns, and triaging to pharmacist as appropriate. Manage multiple clinics with diverse needs autonomously.
Verify patient information and insurance coverage. Work with pharmacy team members and payers to resolve discrepancies and review insurance for affordability.
Demonstrate expertise with prior authorization process by gathering necessary documentation, completing forms, and communicating with healthcare providers and insurance companies to obtain approval for medications.
Display professionalism in all interactions. Communicate effectively in-person, via telephone, and in other electronic communication. Document pertinent patient information professionally and succinctly in patient chart, as agreed upon.
Act as liaison between patient, pharmacy, and other healthcare providers to ensure smooth workflow and effective communication.
Participate in training of new staff.
Oversees continuity of pharmacy processes and adherence to clinical and specialty programs and policies. Participate in quality improvement projects, as deemed relevant and approved by manager.
Stay updated with latest developments in practice area. Participate in training programs and continuing education opportunities to enhance knowledge and skills.
Perform related duties as assigned