Prior Authorization Technician

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

📋 Description

• Oversee the authorization process for pharmacy orders received from clinics.

• Submit prior authorizations on behalf of healthcare providers.

• Follow up on prior authorization requests that have not received a response.

• Track prior authorizations through approval or denial and keep patients, staff, and clinics informed.

• Assist clinicians in acquiring Celgene authorization and confirmation numbers.

• Review and initiate appeals for prior authorizations, including first-level appeal assessments.

• Coordinate appeal reviews with pharmacy benefit manager medical directors and conduct peer-to-peer interviews as necessary.

• Supervise daily pharmacy operations and provide backup support, including PAP, SP follow-ups, BV, and claims adjudication.

• Maintain necessary training and education for permit renewal.

• Educate staff on prior authorization procedures.

• Manage incoming and outgoing communications with patients via calls and emails.

• Direct calls to the appropriate personnel and address patient/clinic inquiries regarding delivery status and prescription updates.

• Follow up on specialty pharmacy orders to guarantee efficient processing.

• Arrange delivery schedules.

⛳️ Requirements

• A high school diploma, GED, or equivalent education is mandatory.

• A minimum of two years’ experience in Retail/Specialty/Hospital Pharmacy as a Pharmacy Technician is preferred.

• Proficiency in medical terminology and strong attention to detail are essential.

• Skills in critical thinking, problem-solving, analysis, decision-making, planning, time management, and organization are required.

• Ability to exercise independent judgment.

• Well-developed interpersonal skills, emotional intelligence, diplomacy, tact, conflict management, delegation skills, and an awareness of diversity.

• Capacity to handle sensitive and confidential material while managing emotionally charged situations effectively.

• Strong oral, written, and presentation communication skills, along with active listening and balanced feedback abilities.

• A solid customer focus and the capability to collaborate with patients, physicians, clinics, staff, and community stakeholders.

• Competence in managing time, conflicting priorities, stress, and professional growth.

• Ability to work independently with minimal supervision and effectively in a remote setting.

• Capacity to operate in a fast-paced, multi-site environment while juggling competing priorities.

• Proficiency in Microsoft Word, Excel, PowerPoint, and Outlook.

• Pharmacy technician registration with the Florida Department of Health in good standing is required.

• A valid state driver's license and adherence to the company's Driver Safety Operations and Motor Vehicle Records Check Policy are required.

🏝️ Benefits

• Comprehensive health insurance options.

• Opportunities for professional development and growth.

• Flexible work hours and supportive work environment.