Pharmacy Technician - Prior Authorization Specialist II or III

Azliver; Mesa (AZ); On-site; USD 65,904,000 - 91,693,000; Full time

Benefits offered by this job

Health, Dental, Vision with HSA plans

CME budget

401K with company match

Sick time

Company holidays

Job summary

Arizona Liver Health in Mesa, AZ is seeking a Pharmacy Technician - Prior Authorization Specialist II or III to support patients needing complex medications for liver disease. You will manage prior authorizations, assist with financial assistance options, and coordinate with payors, pharmacies, and patients.

This full-time role 8am-5pm offers competitive pay of $23-$32 per hour, depending on experience, plus benefits. Strong knowledge of pharmacy operations and EMR software is preferred.

Qualifications

• 1–2 years in Pharmacy Prior Authorizations is required.
• Lead-tech experience is highly preferred.
• Experience with pharmacy operations and policy procedures.
• Ability to work independently with minimal supervision.
• Strong written, verbal, and patient-service communication skills.
• Proficient in Outlook and Excel; accurate data entry.
• Experience with EMR/pharmacy software and insurance benefits.

Responsibilities

• Complete PA requirements and coordinate approvals.
• Facilitate labs/immunizations for payer compliance.
• Interact professionally with patients, payors and pharmacies.
• Assist in training staff on processes and compliance.
• Manage pharmacy software for patient treatment adherence.
• Support coordination of commercial/Medicaid/Medicare services.
• Document information to meet regulatory and risk requirements.
• Communicate decisions for pharmacy requests per clinic policy.
• Escalate complex cases to Nurse Case Manager.

Skills

PA experience

Lead-tech experience

Pharmacy operations knowledge

Policy/procedure development

Independent work

Written/verbal communication

MS Office (Outlook/Excel)

Data entry

EMR/pharmacy software

Insurance benefits knowledge

Education

High school diploma or GED

Associate or bachelor’s in healthcare

CPhT certification (PTCB or NHA) and AZ license

Apexus 340B modules

Experience with day-to-day pharmacy operations

Pharmacy benefits experience

Tools

Microsoft Office

EMR software

Pharmacy software

Job description

Pharmacy Technician - Prior Authorization Specialist II or III

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 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

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
• 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
• 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.
• Health, Dental, Vision (with HSA plans and employer contribution)
• 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

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.