Prior Authorization Technician

Location:
AON Pharmacy
Hiring Range:
$16.00 - $30.21
Position Summary
The Prior Authorization Technician shall be responsible for the authorization process of orders coming into the Pharmacy from AON clinics.
Key Performance Areas
KPA 1 – Prior and REMS Authorizations
Submit prior authorizations on behalf of physicians
Follow up on submitted PA requests when no response is received
Monitor each PA through the process until approved/denied, and inform patient, staff and clinic as indicated.
Responsible for assisting the clinicians in obtaining Celgene authorization and confirmation numbers.
KPA 2 – Appeals
Will review and initiate prior authorization appeal services to include first level appeal reviews. Will coordinate appeal reviews with Medical Director(s) of pharmacy benefit managers and/or peer-to-peer interviews as required.
KPA 3 – Backup to pharmacy staff
Will monitor daily activities and provide backup support where needed, including PAP, SP follow-ups, BV and claims adjudication as needed.
KPA 4 – Education & Training
Responsible for keeping up on all applicable training and education for maintenance of permit.
Will train staff on PA processes.
KPA 5 – Customer Service
Incoming and outgoing calls/emails to patients. Routing of calls to appropriate staff. Answering patient/clinic questions regarding delivery status, Rx updates, etc.
SP follow-up to assure orders are being processed efficiently.
Scheduling deliveries.
Position Qualifications
Education
High school diploma, GED or equivalent education is required
Minimum Relevant Experience
Minimum of two years’ experience in Retail/Specialty/Hospital Pharmacy as a Pharmacy Technician preferred; medical terminology and attention to detail required.
Certifications/Licenses
Pharmacy technician registration with the Florida Dept of Health in good standing required.
Valid state Driver’s License for travel to satellite offices and offsite meetings. Compliance with the company Driver Safety Operations and Motor Vehicle Records Check Policy is required.
Travel: 0%
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