Pharmacy Technician Prior Authorization Specialist

4 hours ago

Dallas, Texas, United States Cloud Rx Pharmacy Full time
Job Title: Pharmacy Technician Prior Authorization Specialist

At Cloud Rx Pharmacy, we are seeking a highly skilled Pharmacy Technician to join our team as a Prior Authorization Specialist. This role plays a vital part in ensuring that patients receive timely approvals for prescription medications that require pre-approval from insurance providers or other relevant entities.

Key Responsibilities:
  • Review prescription orders to identify medications requiring prior authorization and initiate the prior authorization process by collecting and verifying patient information and medical history.
  • Collaborate with healthcare providers and insurance companies to submit accurate requests and ensure completed forms and documentation are attached.
  • Assist patients with the prior authorization process, educate them on its importance and potential outcomes, and address patient concerns and provide medication options.
  • Conduct real-time chats to resolve prior authorization queries, collaborate with the healthcare team for seamless communication, and maintain records and follow up on action items.
  • Perform accurate data entry to update prescription records and patient information, ensuring compliance with regulatory requirements.
  • Manage inbound calls from clients, healthcare professionals, and stakeholders, offering courteous and knowledgeable assistance for inquiries and medication-related concerns.
  • Keep detailed records of prior authorization activities and comply with pharmacy industry regulations and data protection protocols.
  • Participate in quality assurance initiatives, provide feedback to optimize the prior authorization workflow, and stay updated on insurance policies and industry developments.
Requirements:
  • Certification as a Pharmacy Technician (CPhT) by an accredited certifying body.
  • In-depth knowledge of pharmaceuticals, medical terminology, and the prior authorization process.
  • Strong communication and interpersonal skills to effectively liaise with patients, healthcare providers, and insurance companies.
  • Excellent organizational abilities to manage prior authorization requests and clinic chats efficiently.
  • Proficiency in using relevant software and systems for prior authorization submissions and documentation.
  • Attention to detail and accuracy in completing prior authorization forms and related paperwork.
  • Ability to work independently and collaboratively in a fast-paced healthcare environment.
  • Commitment to patient care and ensuring medication access through the prior authorization process.
Work Environment:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodation may be made to enable individuals with disabilities to perform the functions.

Prolonged periods sitting at a desk and working on a computer. Prolonged periods of standing and bending. The employee is frequently required to walk; use hands to finger, handle, or feel; and reach forward with hands and arms. The employee is also occasionally required to sit and stoop, kneel, or crouch. The employee must occasionally lift and/or move up to thirty pounds.

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