Prior Authorization Certified Pharmacy Technician

What You'll Do

• Communicate directly with insurance companies to facilitate medication approvals and prior authorizations.
• Navigate pharmacy operating systems to enter data, adjudicate test claims, and develop follow-up action plans.
• Document patient concerns, prior authorization status, and financial assistance needs across multiple databases, electronic medical records (EMRs), and email platforms.
• Collaborate with physicians' offices to ensure patients receive optimal care and access to prescribed therapies.
• Maintain complete and accurate records of all patient communications and case activity.
• Aid patients with pharmacy insurance claims and medication access challenges.
• Partner closely with pharmacists and pharmacy liaisons to deliver an integrated, high-quality patient care experience.
• Provide compassionate phone support to patients, helping them manage refills, medication adherence, and pharmacy-related questions.
• Research and investigate information to support informed decision-making and patient outcomes.
• Manage, organize, and update data using various database applications.
• Identify operational opportunities, recommend improvements, and support enhanced productivity, quality, and customer service standards.
• Analyze trends, resolve issues, implement solutions, and contribute to continuous process improvement initiatives.
• Serve as a value-added business partner to stakeholders throughout the organization.
• Protect confidential patient and organizational information in accordance with company policies.
• Stay current with industry trends and best practices through continuing education, professional publications, networking, and professional organizations.
• Perform other duties as assigned.

Qualifications

• Minimum 1+ year of Pharmacy Technician experience.
• High School Diploma or GED required.
• State registered or state certified as a Pharmacy Technician, where applicable.
• National certification (CPhT or equivalent) required.

Compensation & Pay Transparency

Shields Health Solutions is committed to pay transparency and equal employment opportunities. Hourly Pay Range: $19.45 - $22.21 per hour. Actual compensation may vary based on factors including, but not limited to: Geographic location, Skills and abilities, Education, Relevant experience, Certifications and licensure, Other job-related considerations.