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The essential functions of a pharmacy technician in Prior Authorization are providing expertise and customer service support to members, customers, and/or providers. Using established criteria and guidelines, the pharmacy technician receives and processes prior authorization requests made by providers and members for medications not inherently covered on a member's prescription drug plan.
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Follow all applicable government regulations including HIPAA. Other duties as assigned; Handle the calls regarding Prior Authorization. Pharmacy Technician with duties of Cycle Fill Technician assisting the pharmacist with preparation of routine medications for distribution to long term care facilities based on physician orders and prescriptions.
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Prepares and processes third party prior authorization forms and follow-up as necessary. The purpose of the Pharmacy Tech Data Entry role is to complete the initial data entry of prescriptions into the Pharmacy operating system to be reviewed and approved by a pharmacist and provide administrative support to the billing department by processing and resolving pharmacy claims based on pharmacy delivery schedules, adding in insurance, tracking prior authorizations, and processing returned medications.
$21.5 - $25 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Managed Care Clinical Pharmacist will provide clinical pharmacy support to the CommunityCare Pharmacy Department including development of criteria for medications requiring a prior authorization, management of the drug utilization protocol, clinical support for the CMS Medication related STARs Measures, Medication Therapy Management (MTM) outreach, and other clinical duties as needed.
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The CTA will prepare Part B medication prior authorization requests for clinical review and will complete prior authorization requests and issue review outcome notifications to providers and members.
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Process and manage prior authorization and non-covered prescription orders. State licensure or registration as a Pharmacy Technician as required by state of practice. National Pharmacy Technician Certification preferred or as required by state of practice.
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Completes Prior Authorization reviews as needed. The pharmacy resident will be responsible for improving patient care through various clinical programs, medication reconciliation, counseling and care management.
$40 - $43 an hourFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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The Revenue Cycle Representative will work closely with other staff within the department to support pharmacy revenue management (e.g., benefits investigation, prior authorization support, copay assistance, patient assistance programs), complete routine pharmacy billing activities, and assist with operational workload (e.g., filling prescriptions, inventory management of repository and free drug programs) in PMAP.
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Obtain prior authorization/continuing authorization for CHP services for clients. The Intake Coordinator is responsible for handling all aspects of the authorization process and assists with front office responsibilities.
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The Pharmacy Technician I (Data Entry) is responsible for the interpretation and data entry of basic prescriptions, prior authorization processing, and troubleshooting adjudication issues.
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The PDP Insurance Billing Specialist will be responsible to perform benefit investigation and obtain prior authorization for both new and existing patients to process and bill patient prescription orders in a timely manner while demonstrating excellent customer service to patients, healthcare professionals and insurance carriers.
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Provides coordination and processing of pharmacy prior authorization requests and/or appeals. Jobs in this family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics regarding patient outcomes, medications safety and medication use policies.
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Full-time retail pharmacy technician position to support Trinity Health Grand Rapids retail pharmacies and new pharmacy business lines including prior authorization support and Epic MSOT. This position will be based out of Wege Pharmacy, but work location may change to any Trinity Health Grand Rapids retail pharmacy based on business needs.
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Our Coverage Review Department (CRD) team seek dedicated, compassionate, and empathetic Prior Authorization Representatives to join our team. Prior Authorization Representative - Remote.
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This position takes in-coming calls from members, providers, etc providing professional phone assistance to all callers through the criteria based prior authorization process. At least year experience as a pharmacy technician coordinating activities in an administrative support function.
$18.92 - $21.24ExpandApply NowActive JobUpdated 25 days ago
prior authorization jobs Title: pharmacy
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