Prior-Authorization Technician

3 weeks ago

Arlington, United States MFA Co Full time
Position Summary

The Prior Authorization Technician will process prior authorizations and locate foundation assistance for GW Medical Faculty Associates providers.

Essential Duties and Responsibilities

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.

Under the direct supervision of a licensed Pharmacist:

  • Initiate prior authorizations for medications and work with providers on completion
  • Confirm patient demographics are accurate and insurance information is correct
  • Communicate with the clinical team and patients about prior authorization status and provide updates accordingly
  • Identify patient foundation assistance and manufacturer copay assistance programs
  • Follow up with the pharmacy to ensure the medication is in process after approval received
  • Process prior authorization renewals
  • Work with the provider to resolve prior authorization denials, peer-to-peer reviews, and denials
  • At all times, maintain a courteous interaction with patients, visitors, departments, and medical personnel
  • Refer issues that require professional judgment to a pharmacist for follow-up
  • Other duties assigned
Minimum Qualifications

Education
  • High school diploma or an equivalent combination of education, training, and experience
Experience
  • A minimum of 2 years of Pharmacy Technician experience in retail, specialty, or mail-order pharmacy and a pharmacy license ( Pharmacy Tech license)
    • A minimum of 2 years in an alternative healthcare role (i.e. Certified Nurse Assistant, Medical Assistant, Licensed Practical Nurse) will be considered
Physical Requirements
  • Stand, walk, bend, twist, and reach for long periods of time in a clinical setting.
  • Must be able to occasionally lift or carry and push or pull up to 100 lbs. as part of the role
  • Regularly exposed to healthcare settings that may require personal protective equipment
  • Requires manual dexterity to operate a computer keyboard, calculator, copier machine, and other equipment.


About GW MFA

MFA physicians provide comprehensive patient care, offering one practice for the whole person with 52 medical and surgical specialties. As members of the GW School of Medicine and Health Sciences faculty, MFA providers are teachers and mentors for medical students, residents, fellows, and researchers preserving the rich tradition of academics, research, and healing. In addition to maintaining a closely integrated alliance with The George Washington University and The George Washington University Hospital (GWUH) which is separately owned and operated by Universal Health Services (UHS), the GW MFA has active referring relationships with 12 area hospitals.

The GW MFA’s leading healthcare presence in the DC metro region is complemented by a network of community-based practices in DC, Maryland, and Virginia. Given its geographic location in central NW Washington, DC, and proximity to more than 175 resident embassies, the MFA continues to evolve its international clinical outreach.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

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