Prior Authorization Specialist/Pharmacy Tech - Worcester, United States - Family Health Center

Description

Job Description

Job Summary:

We are seeking a highly motivated and detail-oriented individual to join our pharmacy team as a Prior Authorization Specialist and Pharmacy Technician. In this dual role, the incumbent will be responsible for efficiently managing prior authorizations while actively supporting pharmacy operations on the bench. The ideal candidate will possess a strong background in pharmacy processes, insurance coordination, and exceptional multitasking abilities.

Responsibilities:

1. Prior Authorization Processing:

• Review and process prior authorization requests for medications, ensuring accuracy and compliance with insurance requirements.

• Communicate effectively with healthcare providers and insurance companies to facilitate the approval process.

• Maintain up-to-date knowledge of insurance formularies, guidelines, and regulations related to prior authorizations.

2. Pharmacy Operations Support:

• Assist in filling prescriptions accurately and efficiently, following established pharmacy procedures.

• Provide excellent customer service by answering phone calls, addressing patient inquiries, and resolving issues.

• Ring out patients at the register, handling transactions accurately and securely.

3. Documentation and Record Keeping:

• Maintain detailed and organized records of prior authorization requests, approvals, and denials.

• Document patient interactions, prescription information, and other relevant details in the pharmacy management system.

4. Collaboration with Pharmacy Team:

• Work collaboratively with pharmacists, technicians, and other staff to ensure seamless workflow in the pharmacy.

• Communicate effectively with team members to coordinate efforts and address any challenges in real-time.

5. Patient Education:

• Provide clear and concise information to patients regarding the prior authorization process, insurance coverage, and medication-related inquiries.

Qualifications:

• High School Diploma or equivalent; completion of a pharmacy technician training program is preferred.

• Prior experience in pharmacy operations and familiarity with prescription filling processes.

• Strong knowledge of insurance processes, especially in the context of prior authorizations.

• Excellent communication and interpersonal skills.

• Detail-oriented with the ability to manage multiple tasks simultaneously.

• Proficient in using pharmacy management systems and other relevant software.

Reporting:

The Pharmacy Director

EOE