Pharmacy Technician - Prior Authorization Specialist II or III

Job Summary:

The Pharmacy Technician - Prior Authorization Specialist II or 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). 

Location: Onsite in Mesa, AZ

Schedule: Full-Time, 8am-5pm, Monday-Friday

Compensation: $23 - $32 per hour, depending on experience and qualifications

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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

Physical demands

• Able to lift at least 15 lbs.
• Able to sit for long periods (at least 50%)
• Able to type and do computer work for long periods.

Travel Requirements

• Some interoffice travel may be required with use of company vehicle or mileage reimbursement.

Benefits & Perks:

• Health, Dental, Vision (with HSA plans and employer contribution)
• 2 weeks PTO
• Continuing Medical Education budget (CME) and time off
• 5 days Sick Time
• 7 Company holidays and 2 half-days
• 401K with company match
• Short & Long Term Disability
• Shared company vehicles for required travel

Work authorization

Must have valid documentation and authorization to work in the U.S.

EEO statement

It is the policy of the Institute for Liver Health DBA Arizona Liver Health and Arizona Clinical Trials to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. This policy relates to all phases of employment, including, but not limited to, recruiting, employment, placement, promotion, transfer, demotion, reduction of workforce and termination, rates of pay or other forms of compensation, selection for training, the use of all facilities, and participation in all company-sponsored employee activities. Provisions in applicable laws providing for bona fide occupational qualifications, business necessity or age limitations will be adhered to by the company where appropriate.

Other duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Other responsibilities may be communicated directly by the reporting manager/supervisor. Duties, responsibilities, and activities may change. Company reserves the right to adjust role scope with or without notice. 

Notice to Staffing Agencies: It is our policy that any and all contact with third party staffing or recruitment vendors come through our Talent Acquisition Team directly. We have an established and preferred network of contracted partners that we engage if and when we deem it necessary. We request that staffing agencies refrain from repeatedly contacting our hiring managers or employees directly. Unsolicited resumes, onsite solicitations, and inquiries will not be considered or responded to. Overly persistent or pushy inquires may also be blocked across our network as spam. Thank you for your understanding and cooperation.