Prior Authorization Technician

American Oncology Network•Fort Myers, FL

2d•$19 - $32•Onsite

About The Position

The technician shall be responsible for the authorization process of orders coming into the Pharmacy from clinics. This role involves managing prior and REMS authorizations, including submitting requests, following up on responses, and monitoring approvals/denials. The technician will also assist clinicians with specific authorization processes, handle appeals, provide backup support to pharmacy staff, and be responsible for ongoing training and education. Additionally, the role requires excellent customer service skills for interacting with patients and clinics, scheduling deliveries, and ensuring efficient order processing.

Requirements

High school diploma, GED or equivalent education is required
Minimum of two years’ experience in Retail/Specialty/Hospital Pharmacy as a Pharmacy Technician preferred
Medical terminology required
Attention to detail required
Critical thinking skills including solid problem solving, analysis, decision-making, planning, time management and organizational skills.
Must be detailed oriented with the ability to exercise independent judgment.
Developed interpersonal skills, emotional intelligence, diplomacy, tact, conflict management, delegation skills, and diversity awareness.
Ability to work effectively with sensitive and confidential material and sometimes emotionally charged matters.
Effective communication skills (oral, written, presentation), is an active listener, and effectively provides balanced feedback.
Strong customer focus.
Ability to build an engaging culture of quality, performance effectiveness and operational excellence through best practices, strong business and political acumen, collaboration and partnerships, as well as a positive employee, physician and community relations.
Effectively manages own time, conflicting priorities, self, stress, and professional development.
Self-motivated and self-starter with ability work independently with limited supervision.
Ability to work remotely effectively as required.
Must be able to work effectively in a fast-paced, multi-site environment with demonstrated ability to juggle competing priorities and demands from a variety of stakeholders and sites.
Proficiency in MS Office Word, Excel, Power Point, and Outlook required.
Pharmacy technician registration with the Florida Dept of Health in good standing required.
Valid state Driver’s License for travel to satellite offices and offsite meetings.
Compliance with the company Driver Safety Operations and Motor Vehicle Records Check Policy is required.

Nice To Haves

Previous experience in Retail/Specialty/Hospital Pharmacy as a Pharmacy Technician

Responsibilities

Submit prior authorizations on behalf of physicians
Follow up on submitted PA requests when no response is received
Monitor each PA through the process until approved/denied, and inform patient, staff and clinic as indicated.
Assist clinicians in obtaining Celgene authorization and confirmation numbers.
Review and initiate prior authorization appeal services to include first level appeal reviews.
Coordinate appeal reviews with Medical Director(s) of pharmacy benefit managers and/or peer-to-peer interviews as required.
Monitor daily activities and provide backup support where needed, including PAP, SP follow-ups, BV and claims adjudication as needed.
Keep up on all applicable training and education for maintenance of permit.
Train staff on PA processes.
Handle incoming and outgoing calls/emails to patients.
Route calls to appropriate staff.
Answer patient/clinic questions regarding delivery status, Rx updates, etc.
Follow up with SP to assure orders are being processed efficiently.
Schedule deliveries.