Central Prior Authorization Pharmacy Technician

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Oversee and process prior authorization requests related to specialty medications.

• Engage with provider offices, patients, payers, and specialty pharmacies to secure clinical documentation and obtain authorization approvals.

• Submit, monitor, and track prior authorization requests via payer portals, fax, phone, and electronic systems.

• Follow up on outstanding prior authorizations, appeals, renewals, and denials to guarantee prompt patient access.

• Verify patient insurance coverage, benefits, and requirements for specialty pharmacies.

• Input necessary information into the pharmacy management system and keep project details current.

• Collect, analyze, and organize data from various sources.

• Precisely enter required information into databases, documents, or spreadsheets.

• Collaborate with pharmacy operations, sales, and data teams.

• Support ongoing data projects.

• Utilize the pharmacy system to retrieve patient and drug information and process prescriptions.

• Manage prescription refills for integrated offices.

• Apply manufacturer copay cards when applicable.

• Engage in continuous quality improvement initiatives.

⛳️ Requirements

• Experience as a Pharmacy Technician.

• Preferred experience with specialty medications and prior authorization processes.

• Knowledge of commercial, Medicare, and Medicaid insurance plans.

• Familiarity with specialty pharmacy workflows and reimbursement procedures.

• Understanding of the prescription adjudication process.

• Capability to learn pharmacy management systems to extract relevant data.

• Effective communication skills across various organizational levels.

• Ability to read, understand, and compose correspondence.

• Competence in presenting information in individual and small group settings.

• Understanding and application of basic mathematical principles.

• Capacity to apply common sense reasoning.

• Strong analytical and problem-solving abilities.

• Excellent interpersonal, negotiation, and conflict resolution skills.

• Proficiency in Word and Excel or similar software.

• Comfortable using RingCentral and experienced in patient outreach.

• Preferred experience with payer portals such as CoverMyMeds or similar authorization platforms.

• Must adhere to Apotheco information security policies, employee handbook, and regulatory requirements regarding security and privacy.

• Strong skills in time management, oral and written communication, professionalism, organization, customer service, prioritization, attention to detail, multitasking, goal orientation, dependability, confidentiality, self-motivation, and teamwork.

• Willingness to participate in continuous quality improvement activities.

🏝️ Benefits

• Remote, home-based position.

• Reliable internet access and a private workspace for confidential patient interactions.