Central Prior Authorization Pharmacy Technician

Job not on LinkedIn

🔥 15 minutes ago

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

💵 $22 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

👻 Ghost score 0%

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Apotheco Pharmacy

WebsiteLinkedInAll Job Openings

201 - 500 employees

💊 Pharmaceuticals

🏥 Healthcare

🛒 Retail

💰 Private equity on 2023-09

Pharmaceuticals • Healthcare • Retail

Apotheco Pharmacy is a U. S. -based, tech-enabled pharmacy network that has served dermatologists and their patients for over 13 years. With 39+ locations nationwide, Apotheco provides specialty pharmacy services focused on dermatology (and other multi-specialty areas) including branded and generic medication savings, compounded and personalized medications, direct-to-patient prescription delivery, cash-pay and commercial fulfillment, and OTC integration. The company emphasizes practice and prescriber workflow integration through EMR and e-prescribing (eRx) connectivity, prior-authorization support, digital patient engagement and adherence programs, and a national pharmacy network to streamline practice operations and improve patient access and outcomes.

📋 Description

• Manage and process prior authorization requests for specialty medications • Communicate with provider offices, patients, payers, and specialty pharmacies to obtain clinical documentation and authorization approvals • Submit, monitor, and track prior authorization requests through payer portals, fax, phone, and electronic systems • Follow up on pending prior authorizations, appeals, renewals, and denials to ensure timely patient access • Verify patient insurance coverage, benefits, and specialty pharmacy requirements • Enter and maintain project information in the pharmacy management system • Receive, analyze, gather, and organize data from multiple sources • Enter required data into databases, documents, and spreadsheets • Collaborate with pharmacy operations, sales, and data teams • Support existing data projects • Use the pharmacy system to obtain patient and drug information and process prescriptions • Manage prescription refills for integrated offices • Apply manufacturer copay cards when applicable • Participate in continuous quality improvement activities • Handle patient information securely and confidentially in accordance with company policies and regulatory requirements

🎯 Requirements

• Pharmacy technician experience • Experience with specialty medications and prior authorization processes preferred • Knowledge of commercial, Medicare, and Medicaid insurance plans • Familiarity with specialty pharmacy workflows and reimbursement procedures • Familiarity with prescription adjudication processes • Ability to learn pharmacy management systems and extrapolate pertinent data • Effective communication across various organizational levels • Ability to read, comprehend, and write correspondence • Ability to present information effectively in one-on-one and small group situations • Ability to comprehend and apply basic math principles • Strong analytical and problem-solving skills • Excellent interpersonal, negotiation, and conflict resolution skills • Proficiency in Word and Excel or related software • Comfortable using RingCentral and experience with patient outreach • Experience using payer portals such as CoverMyMeds or similar authorization platforms preferred • Ability to comply with information security policies, employee handbook, and security and privacy regulatory requirements • Time management, oral and written communication, professionalism, organization, customer service, prioritization, attention to detail, multitasking, goal orientation, dependability, confidentiality, and self-motivation • Ability to work well with various departments and within a team • Must be able to perform essential duties satisfactorily and manage required tasks

🏖️ Benefits

• Remote, home-based position • Reliable internet access and private workspace for confidential patient interactions • Reasonable accommodation may be made for individuals with disabilities • Continuous quality improvement activities