Pharmacy Technician - Prior Authorization Specialist II

 

About Us:

Arizona Liver Health (ALH) is dedicated to driving high standards of care and advancing medical innovation through leading clinical trials, ensuring patient safety and regulatory compliance, and generating high-quality clinical data. Our network of multiphase, multitherapeutic research, standard of care, and VEN Centers sites is staffed by skilled providers, research, clinic, pharmacy, and patient outreach professionals. ALH operates state-of-the-art facilities and programs to meet the evolving needs of clinical research and overall patient treatment.

 

Job Summary:

The Pharmacy Technician - Prior Authorization Specialist III is a crucial part of the healthcare team to assist patients in providing specialized, complex medications for their liver disease and/or condition. This includes obtaining authorizations, navigating financial assistance options, and working with patients, payors, and pharmacies. The prior authorization specialist takes care of the prescription from the time it is ordered to ensuring the patient receives the medication(s). 

Schedule: Onsite in Mesa, AZ or Peoria, AZ, Full-Time, 8am-5pm Monday-Friday

Compensation: $23 - $28 per hour, depending on experience

Essential job functions/duties 

Reasonable accommodation may be made to enable individuals with disabilities to perform these essential functions.  

• Assure all prior authorizations (PA) requirements are complete. 
• Facilitate labs/immunization completion for patient payor compliance.
• Interact professionally with patients, peers, and other outside vendors as required. 
• Assists in training new pharmacy staff along with level III PA Specialists on organizational processes and compliance procedures
• Manage pharmacy software for patient compliance with treatment.
• Supports comprehensive coordination of commercial, Medicaid and/or Medicare pharmacy services including intake and processing of pharmacy authorization requests. 
• Promotes and supports quality effectiveness of healthcare and Pharmacy Services within clinical setting
• Evaluates, aids in authorizing approval, and communicates decisions for pharmacy requests according to clinic process
• Evaluates and aids in authorizing approval of pharmacy requests received by telephone, facsimile, and/or other means using client clinical criteria
• Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements with minimal supervision
• Process requests in compliance with various laws and CMS regulations and company policies and procedures
• May communicate with payors, external pharmacies, patients, case managers, electronic PA platforms
• Promotes communication, both internally and externally, to enhance effectiveness of medication therapy management services
• Escalates requests to Nurse Case Manager when request requires extensive clinical review or denial

Knowledge/Skills/Abilities Required 

• At least one to two (1-2) years of experience working in Pharmacy Prior Authorizations required
• Previous lead-tech experience highly preferred
• Prior experience and working knowledge with pharmacy operations
• Prior experience assisting in preparing detailed policy and procedures for accrediting agencies preferred
• Ability to work independently with minimal day-to-day supervision
• Excellent written, verbal, and interpersonal/patient-service communication skills required
• Proficient in Microsoft Office including Outlook and Excel
• Intermediate-level data entry computer skills with high attention to detail
• Bilingual (English/Spanish) preferred
• Ability to multi-task between different platforms, programs
• EMR or pharmacy software proficiency required
• Good working level knowledge of pharmacy insurance benefits required

Education, credentials, and/or trainings required:

• High school diploma or GED from an accredited institution required
• Associate or bachelor’s degree in pharmaceutical or healthcare related field preferred
• CPhT Certification (PTCB or NHA) and Arizona License in good standing preferred.
• Complete Apexus 340B on-line Modules upon hire
• Experience with all aspects of the day- to -day pharmacy operations
• Prior pharmacy benefits experience required.

Supervisory responsibilities

• None

Work environment

• Office / Clinic setting<