Clinical Pharmacy Technician

About This Role

Process prior authorization requests for healthcare organizations, ensuring accuracy and timeliness, while adhering to clinical protocols and client guidelines. This role involves analyzing information, making determinations, and interacting with internal and external customers to provide excellent service.

Responsibilities

• Process and finalize prior authorization requests within client turnaround times and performance guarantees
• Achieve prior authorization processing productivity and accuracy standards
• Enter prior authorizations into the system and prioritize requests
• Check formulary alternatives and review tried and failed medications
• Utilize drug references and verify drug indication and approval for the condition
• Document all related information regarding prior authorization approval or non-approval
• Analyze, research, and resolve prior authorization processing issues
• Coordinate outbound communication to members, physicians, and pharmacies to obtain missing information
• Maintain confidentiality and privacy of all prior authorization and member information
• Identify and recommend operational improvements

Requirements

• Ability to work in a fast-paced and high-functioning environment
• Moderate-to-high level of medication and disease state knowledge
• Personal computer literacy and high competency in using Microsoft Word, Excel, Adobe
• Strong organizational skills with attention to detail
• Strong oral and written communication skills
• Excellent critical thinking capabilities
• Exceptional customer service skills
• Active Certified Pharmacy Technician (State or National License)

Qualifications

• High school diploma or equivalent
• Minimum one-year prior authorization experience preferred

Nice to Have

• One-year prior authorization experience
• Health plan or Pharmacy Benefit Manager experience

Skills

* Required skills

Benefits