Prior Authorization Pharmacy Technician

🔥 9 minutes ago

🏄 California, Hawaii, +1 more states – Remote

🏄 California – Remote 🌺 Hawaii – Remote 🗽 New York – Remote

⏰ Full Time

🟢 Junior

💊 Pharmacist

🚫👨‍🎓 No degree required

👻 Ghost score 10%

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Shields Health Solutions

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2011

💼 Consulting

📦 Logistics

🏥 Healthcare

Consulting • Logistics • Healthcare

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

• Support patient care by removing barriers to medication access • Work with insurance companies and clinician offices to facilitate medication approvals through prior authorizations • Collaborate with patients, foundations, and pharmaceutical manufacturers to obtain financial assistance for high-cost copays • Provide phone support to patients and promote medication adherence and compliance • Navigate pharmacy dispensing systems to adjudicate claims and process refills • Communicate with insurance companies regarding medication approvals • Input data, adjudicate test claims, and develop follow-up action plans in pharmacy operating systems • Document patient concerns, prior authorization status, and financial assistance needs across databases, electronic medical records, and email systems • Review prescriptions with physicians’ offices • Maintain complete and accurate patient communication records • Assist patients with pharmacy insurance claims • Collaborate with pharmacists and pharmacy liaisons to deliver coordinated patient care • Research and analyze information for strategic decision-making • Manage, organize, and update database information • Improve operations, productivity, quality, and customer service standards • Identify trends, resolve issues, recommend improvements, and implement changes • Participate in process improvement initiatives • Act as a value-added business partner to organizational stakeholders • Maintain confidentiality of information • Maintain professional knowledge through education, publications, and professional networks • Perform other assigned duties

🎯 Requirements

• Experienced, state-registered pharmacy technician • Candidates in Delaware, Hawaii, or New York must obtain a state license within 6 months of employment • Candidates in Delaware, Hawaii, or New York must be nationally certified through PTCB or NHA at time of hire • In other states, PTCB or NHA certification is highly preferred but not required; certification must be obtained within 9 months of employment • Required licensure must be obtained within a mutually agreed-upon timeframe when applicable • Continued employment is contingent upon meeting licensure/certification requirements • At least 1 year of experience as a Pharmacy Technician • High school diploma or GED required • Solid computer skills • Proficiency with Microsoft Outlook, Teams, Word, Excel, and PowerPoint • Ability to navigate the internet and web-based platforms • Data entry and computer skills evaluated during pre-employment assessment • Ability to work Monday through Friday and occasional weekend rotations • Minimal in-state or out-of-state travel may be required

🏖️ Benefits

• Full-time Monday–Friday schedule • Occasional weekend rotation as needed during busy/holiday seasons • Educational opportunities, professional publications, and professional networks/organizations • Equal employment opportunities and inclusive hiring support • Application/interview accommodations available • Job-opportunity, interview-scheduling, and recruiting-update text messages available with consent; opt-out permitted