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Shields Health Solutions · 1 day ago

Pharmacy Technician Prior Authorization Specialist

United States

Full-time

Remote

Entry Level

1+ years exp

Shields Health Solutions is focused on providing patient care by removing barriers to medication access. The Pharmacy Technician Prior Authorization Specialist will facilitate medication approvals through insurance companies and assist patients in managing their pharmacy insurance claims.

BiopharmaHealth CareMedicalPharmaceutical

Growth Opportunities

Responsibilities

Directly communicate with insurance companies to facilitate the approval of medications

Navigate pharmacy operating systems to input data, perform adjudication on test claims and prepare action plans for follow-up

Effectively communicate across databases, electronic medical records and emails to document patient concerns, prior authorization status, and financial assistance needs

Review prescriptions with doctors' offices to ensure optimal care of the patient

Keep complete and accurate records of patient communications

Assist patients in the management of their pharmacy insurance claims

Work closely with pharmacists and pharmacy liaisons to provide an integrated approach quality patient care

Communicate directly with patients over the phone to assist them in all aspects of medication compliance

Research and investigate information to enable strategic decision-making by others

Manage, organize, and update relevant data using database applications

Apply observations and recommendations to operational issues, increased productivity, quality, and customer-service standards

Identify trends, resolve problems; recommend improvements; implement change

Actively participate in process improvement initiatives

Act as a value-added business partner to stakeholders throughout the organization

Protect organization's value by keeping information confidential

Update job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations

Minimal in or out of state travel may be required

Perform other duties as assigned