Central Prior Authorization Pharmacy Technician

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

📋 Description

• Oversee and handle prior authorization requests for specialty medications.

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

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

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

• Confirm patient insurance coverage, benefits, and specialty pharmacy requirements.

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

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

• Precisely enter necessary data into databases, documents, or spreadsheets.

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

• Assist with ongoing data projects.

• Utilize the pharmacy system to gather patient and drug information and manage prescriptions.

• Oversee prescription refills for integrated offices.

• Apply manufacturer copay cards when applicable.

• Adhere to company policies, procedures, confidentiality standards, and remote-work security protocols.

• 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 protocols.

• Understanding of the prescription adjudication process.

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

• Effective communication skills across various organizational levels.

• Proficient in reading, comprehending, and writing correspondence.

• Ability to present information clearly in individual and small group settings.

• Competence in basic math principles.

• Employ common sense understanding in various situations.

• Strong analytical and problem-solving capabilities.

• Excellent interpersonal, negotiation, and conflict resolution abilities.

• Proficient in Word and Excel or similar software.

• Comfort using RingCentral and experience with patient outreach.

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

• Ability to comply with Apotheco’s information security policies, employee handbook, and security and privacy regulations.

• Skills in time management, communication (both oral and written), professionalism, organization, customer service, prioritization, multitasking, goal orientation, dependability, confidentiality, and self-motivation.

• Ability to collaborate effectively with various departments and function well within a team.

• Participate in ongoing quality improvement initiatives.

• Must have reliable internet access and a private workspace for remote work.

🏝️ Benefits

• Remote, home-based role.

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

• Reasonable accommodations may be provided to enable individuals with disabilities to perform essential functions.