Patient Access Advocate: Prior Authorization Specialist

Shields Health Solutions; New Hampshire; On-site; USD 42,000 - 53,000; Full time

Job summary

Shields Health Solutions in New Hampshire is seeking a Patient Support Advocate who is a licensed Pharmacy Technician. You will advocate for patients, manage prior authorizations, assist with insurance navigation, and coordinate financial assistance to improve access to medications.

The role combines patient advocacy, insurance support, and pharmacy operations to positively impact patient outcomes daily. A NH registration or national certification is required or strongly preferred where

Qualifications

• Minimum 1 year of Pharmacy Technician experience.
• Strong customer service and patient communication skills.
• Experience working with insurance claims, medication access, prior authorizations, or pharmacy operations preferred.
• New Hampshire State Registered and/or State Certified Pharmacy Technicians (where applicable).
• National certification (CPhT) is strongly preferred but not required.
• If the candidate's state of residence does not offer pharmacy technician registration, national certification is required at the time of hire.
• Continued employment is contingent upon maintaining required licensure and certification requirements.

Responsibilities

• Communicate with insurance companies to facilitate approvals through prior authorizations.
• Help patients access financial assistance through foundations and manufacturer programs.
• Navigate pharmacy systems to enter data, adjudicate claims, process refills, and create follow-up action plans.
• Document patient concerns, prior authorization status updates, and financial assistance needs across databases and EMR systems.
• Collaborate with physicians' offices to ensure timely and appropriate medication therapy.

Skills

Customer service

Patient communication

Insurance claims

Pharmacy operations

Education

High School Diploma or GED

Tools

Microsoft Office

EMR systems

Job description

Shields Health Solutions in New Hampshire is seeking a Patient Support Advocate who is a licensed Pharmacy Technician. You will advocate for patients, manage prior authorizations, assist with insurance navigation, and coordinate financial assistance to improve access to medications.

The role combines patient advocacy, insurance support, and pharmacy operations to positively impact patient outcomes daily. A NH registration or national certification is required or strongly preferred where