Prior Authorization Technician

Artificial IntelligenceArtificial IntelligenceFull TimeRemoteTeam 1,001-5,000

Location

United States

Posted

9 days ago

Salary

$19 - $32 / hour

No structured requirement data.

Job Description

Location:

Remote Position

Pay Range:

$18.93 - $31.56

Position Summary: 

The technician shall be responsible for the authorization process of orders coming into the Pharmacy from 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/Requirements:

Education: High school diploma, GED or equivalent education is required

Previous Experience: Minimum of two years’ experience in Retail/Specialty/Hospital Pharmacy as a Pharmacy Technician preferred; medical terminology and attention to detail required.

Core Capabilities:

  • Analysis & Critical Thinking: Critical thinking skills including solid problem solving, analysis, decision-making, planning, time management and organizational skills. Must be detailed oriented with the ability to exercise independent judgment.
  • Interpersonal Effectiveness: Developed interpersonal skills, emotional intelligence, diplomacy, tact, conflict management, delegation skills, and diversity awareness. Ability to work effectively with sensitive and confidential material and sometimes emotionally charged matters.
  • Communication Skills: Effective communication skills (oral, written, presentation), is an active listener, and effectively provides balanced feedback.
  • Customer Service & Organizational Awareness: Strong customer focus. Ability to build an engaging culture of quality, performance effectiveness and operational excellence through best practices, strong business and political acumen, collaboration and partnerships, as well as a positive employee, physician and community relations.
  • Self-Management: Effectively manages own time, conflicting priorities, self, stress, and professional development. Self-motivated and self-starter with ability work independently with limited supervision. Ability to work remotely effectively as required.  
  • Must be able to work effectively in a fast-paced, multi-site environment with demonstrated ability to juggle competing priorities and demands from a variety of stakeholders and sites.
  • Computer Skills:
    • Proficiency in MS Office Word, Excel, Power Point, and Outlook 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%

Standard Work Days/Hours : Monday to Friday 9:00 AM – 5:30 PM. 

#LI-REMOTE

Related Job Pages

More Artificial Intelligence Jobs

Travel Reservation Consultant

Beths Beautiful Destinations

This is your chance to turn travel into a fulfilling career with cutting-edge tools, strong industry backing, and complete flexibility. Whether you’re looking for a side gig or a long-term career, start your adventure with us today!

Artificial Intelligence9 days ago
Full TimeRemoteTeam 11-50

This remote role is ideal for someone who enjoys helping others, managing reservations, and delivering excellent customer service in a flexible, work-from-home environment. Assist clients with travel inquiries and reservation requests Book and manage flights, accommodations, crui...

United States + 15 moreAll locations: United States, United Kingdom, Germany, France, Italy, Colombia, Ireland, New Zealand, Spain, Mexico, Costa Rica, Bahamas, Dominican Republic, Honduras, Jamaica, Panama

Product Developer - Floorcare Extraction

SharkNinja

Product design and technology company positively impacting people's lives every day in homes around the world.

Artificial Intelligence9 days ago
Full TimeRemoteTeam 1,001-5,000Since 1994H1B Sponsor

The Product Developer leads the New Product Development process at SharkNinja, ensuring timelines and quality while managing cross-functional teams to deliver products efficiently.

ExcelMs ProjectPowerPointVisio
United States
$56.3K - $112.5K / year

Director, Strategic Growth – AI Services

TaskUs

Digital Customer Experience. Trust & Safety. AI Services.

Artificial Intelligence9 days ago
Full TimeRemoteTeam 10,001+Since 2008H1B Sponsor

Director of Strategic Growth leading AI services expansion at TaskUs.

United States
$110K - $150K / year

Remote Daytime General Radiologist

Radiology Partners

Radiology Partners, through its owned and affiliated practices, is a leading radiology practice in the U.S., serving hospitals and other healthcare facilities across the nation. As a physician-led and physician-owned practice, we advance our bold mission by innovating across clinical value, technology, service and economics, while elevating the role of radiology and radiologists in healthcare.

Artificial Intelligence9 days ago
Full TimeRemoteTeam 5,001-10,000

The role involves providing radiology services to hospitals and other healthcare facilities across the nation as part of a physician-led and physician-owned practice. The focus is on advancing clinical value, technology, service, and economics while elevating the role of radiology.

United States