Specialty Pharmacy Technician - Prior Authorizations

About the role

A Specialty Medication Coordinator is responsible for managing third-party billing or patient financial assistance for patients within the health system. This includes assisting with the management and processing of high-dollar specialty medications, benefits investigation, obtaining prior authorizations, copay/foundation assistance, drug replacement services, and patient financial counseling.

Responsibilities

• Timely process referrals and submit clinical supporting documentation to expedite prior authorization and/or patient assistance processes.
• Collaborate with other departments to assist in obtaining prior authorizations, patient assistance medications, or financial assistance.
• Absorb medical necessity documentation to expedite approvals and ensure appropriate follow-up.
• Follow prior authorization and/or patient assistance workflows and policies/procedures.
• Demonstrate the ability to work independently, meet deadlines, and possess excellent time management skills.
• Perform tasks accurately and efficiently.
• Possess excellent interpersonal, customer service, and communication skills (both written and verbal); timely responses to key stakeholders.
• Accurate documentation of all intake referrals and/or prior authorization information in patient medical record or patient assistance tracking software in compliance with policy and procedure/workflow.
• Proactively track and manage patient refills/outreach to ensure timely prescription/infusion service.
• Proactively work on prior authorization and patient assistance enrollments that are due to expire.
• Secure patients’ demographic and medical information in compliance with organization HIPAA policies and procedures.
• Assist management with inspections, audits, reports, and training to ensure compliance with standards and to provide quality service.

Qualifications

• Program Graduate, Pharmacy Technician Training Program or equivalent (Preferred)
• Program Graduate, Licensed Practical Nurse (Required)
• Program Graduate, Certified Medical Assistant (Required)
• 3-4 years Experience as a Pharmacy Technician, LPN, or CMA (in lieu of education) (Required)
• 1 year Experience obtaining and managing medication prior authorization as part of job function (Preferred)
• 1 year Prior Experience obtaining and managing patient assistance program applications (Preferred)

Skills and Abilities

• Familiar with medical and pharmacy terminology
• Prescription drug and over-the-counter knowledge
• Basic math skills, including pharmaceutical calculations
• Basic pharmacy workflow
• Understanding pharmacy computer systems
• Ability to navigate and read electronic health record
• Strong written and verbal communication skills
• Ability to prioritize, problem solve, and multitask
• Excellent customer service skills
• Knowledge of patient assistance programs
• Experience with prior authorization of medications
• Strong organizational skills and detail oriented
• Advanced certification in specialty pharmacy field (PTCB, ASHP, NCODA and other approved programs) (Preferred)

Benefits

The actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs.

Pay

Hiring range is $23.90 - $31.10/Hourly.

Schedule

N/A

Contact

To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers.