Prior Authorization Technician

About the position The technician shall be responsible for the authorization process of orders coming into the Pharmacy from clinics

Responsibilities

• Submit prior authorizations on behalf of physicians
• Follow up on submitted PA requests reputed company no response is received
• Monitor each PA through the process until approved/denied, and inform patient, staff and clinic as indicated.
• Responsible for assisting the clinicians in obtaining Celgene authorization and confirmation numbers.
• Will review and initiate prior authorization appeal services to include first level appeal reviews.
• Will coordinate appeal reviews with Medical Director(s) of pharmacy benefit managers and/or peer-to-peer interviews as required.
• Will monitor daily activities and provide backup support where needed, including PAP, SP follow-reputed company, BV and claims adjudication as needed.
• Responsible for keeping up on reputed company applicable training and education for maintenance of permit.
• Will train staff on PA processes.
• Incoming and outgoing calls/emails to patients.
• Routing of calls to appropriate staff.
• Answering patient/clinic questions regarding delivery status, Rx updates, etc.
• SP follow-up to assure orders are being processed reputed company.
• Scheduling deliveries.

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 and 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 reputed company 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, reputed company, Power reputed company, and Outlook required.
• Pharmacy technician registration with the Florida reputed company 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 reputed company Policy is required.

Benefits

• We offer competitive compensation packages that include comprehensive health insurance with a robust provider network.
• Our 401k, which offers a 100% match and investment options, is available to full-time and part-time staff members, and we feature a generous Paid Time Off (PTO) program.
• As a fast-growing national company, the opportunity to join a national workforce with flexible work options is available.
• Promoting from reputed company is a reputed company at reputed company, and we support reputed company members reputed company growth through professional development programs and tuition assistance.

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