Pharmacy Precertification Specialist

Methodist Le Bonheur Healthcare; Memphis (TN); On-site; USD 42,000 - 64,000; Full time

Job summary

Methodist Le Bonheur Healthcare is hiring a Pharmacy Technician focused on precertification of prescription medications for both inpatient and outpatient services. You will verify that documentation aligns with insurer medical necessity and payment guidelines while coordinating with physicians and patient services to ensure timely approvals.

The role requires 3–5 years of pharmacy experience, completion of a Pharmacy Technician Certification Board credential, and Tennessee licensure.

Qualifications

• High School Diploma or Equivalent.
• Pharmacy (clinical, hospital, outpatient, or specialty) 3–5 years experience.
• Pharmacy Technician Certification Board certification.
• Tennessee Pharmacy Technician license required.
• ExCPT certification preferred; Mississippi license preferred.

Responsibilities

• Precertification of eligible prescription medications for inpatient and outpatient services.
• Ensure documentation meets insurer medical necessity requirements.
• Review clinical information to evaluate necessity and efficiency of medication use.
• Assist with patient assistance and grant coordination for outpatient pharmacies.
• Identify trends and root causes to improve precertification processes.

Skills

Prescription processing

Attention to detail

Communication skills

Patient interaction

Healthcare terminology

Education

Pharmacy Technician Certification Board

Tennessee Board of Pharmacy license

High School Diploma or equivalent

ExCPT (preferred)

Mississippi Board of Pharmacy (preferred)

Tools

EMRs

Microsoft Word

Job description

Methodist Le Bonheur Healthcare is hiring a Pharmacy Technician focused on precertification of prescription medications for both inpatient and outpatient services. You will verify that documentation aligns with insurer medical necessity and payment guidelines while coordinating with physicians and patient services to ensure timely approvals.

The role requires 3–5 years of pharmacy experience, completion of a Pharmacy Technician Certification Board credential, and Tennessee licensure.