Prior Authorization Technician - Pharmacy Technician

GlobalRemote

Responsibilities

Review prescriptions with doctors' offices to ensure optimal care of the patient.
Research and investigate information to enable strategic decision-making by others.
Manage, organize, and update relevant data using database applications.
Identify trends, resolve problems; recommend improvements; implement change.
Update job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations.
Perform other duties as assigned.

Required Licensure/Certification : We are seeking experienced pharmacy technicians who are state registered, or state certified as a pharmacy technician. Nationally certified as a CPhT or equivalent is strongly preferred but not required.
*If the candidate's state of residence does not have a state registration available, then the National certification is required at time of hire. Should additional licensure need to be obtained, the applicant will commit to obtaining the required licensure within a mutually agreed upon timeframe.
Education : High school diploma or GED required

Working with insurance companies and clinician offices to facilitate approval of medications through prior authorizations.
Directly communicate with insurance companies to facilitate the approval of medications.
Assist patients in the management of their pharmacy insurance claims.
Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Within this role, this person will provide patient care by removing the barriers to medication access.
Working with patients and a variety of funding sources such as foundations, or directly through manufactures to obtain financial assistance for high dollar co-pays. Provide phone support to patients by navigating a variety of pharmacy dispensing systems to adjudicate claims, refill medications, and increase adherence in patients. Job Duties:
Effectively communicate across databases, electronic medical records and emails to document patient concerns, prior authorization status, and financial assistance needs.
Keep complete and accurate records of patient communications.
Work closely with pharmacists and pharmacy liaisons to provide an integrated approach quality patient care.
Communicate directly with patients over the phone to assist them in all aspects of medication compliance.
Apply observations and recommendations to operational issues, increased productivity, quality, and customer-service standards.
Actively participate in process improvement initiatives.
Act as a value-added business partner to stakeholders throughout the organization.
Protect organization's value by keeping information confidential.