Prior Authorization Certified Pharmacy Technician

🔥 10 minutes ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

💵 $19 - $22 / hour

⏰ Full Time

🟢 Junior

💊 Pharmacist

🚫👨‍🎓 No degree required

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Shields Health Solutions

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2011

⚕️ Healthcare Insurance

💊 Pharmaceuticals

☁️ SaaS

Healthcare Insurance • Pharmaceuticals • SaaS

Shields Health Solutions is a company that specializes in providing integrated specialty pharmacy solutions. They focus on eliminating disruptions in patient care by offering a comprehensive model that bridges the gap between patients and the specialty medications they need. Shields Health Solutions partners with healthcare providers and drug manufacturers to optimize the impact of specialty pharmacy services. Their approach leverages a clinical model, expert care teams, and a proprietary technology platform to improve patient access to specialty drugs, while reducing the overall cost of care. Shields Health Solutions aims to enhance patient experiences and health outcomes through their innovative solutions in specialty pharmacy integration.

📋 Description

• Communicate directly with insurance companies to facilitate medication approvals and prior authorizations. • Navigate pharmacy operating systems to enter data, adjudicate test claims, and develop follow-up action plans. • Document patient concerns, prior authorization status, and financial assistance needs across multiple databases, EMRs, and email platforms. • Collaborate with physicians' offices to ensure patients receive optimal care and access to prescribed therapies. • Maintain complete and accurate records of all patient communications and case activity. • Assist patients with pharmacy insurance claims and medication access challenges. • Partner closely with pharmacists and pharmacy liaisons to deliver an integrated, high-quality patient care experience. • Provide compassionate phone support to patients, helping them manage refills, medication adherence, and pharmacy-related questions. • Research and investigate information to support informed decision-making and patient outcomes. • Manage, organize, and update data using various database applications. • Identify operational opportunities, recommend improvements, and support enhanced productivity, quality, and customer service standards. • Analyze trends, resolve issues, implement solutions, and contribute to continuous process improvement initiatives. • Serve as a value-added business partner to stakeholders throughout the organization. • Protect confidential patient and organizational information in accordance with company policies. • Stay current with industry trends and best practices through continuing education, professional publications, networking, and professional organizations. • Perform other duties as assigned.

🎯 Requirements

• Minimum 1+ year of Pharmacy Technician experience • High School Diploma or GED required • State registered or state certified as a Pharmacy Technician, where applicable • National certification (CPhT or equivalent) required

🏖️ Benefits

• Shields Health Solutions is committed to pay transparency and equal employment opportunities.