Pharmacy Technician Prior Authorization Specialist - Infusion Services

IHA; Grand Rapids (MI); On-site; USD 42,000 - 56,000; Full time

Job summary

IHA is seeking a Prior Authorization Technician to coordinate PA requests across multiple ambulatory clinics in Michigan. You will manage payer requirements, submit PA requests, and coordinate appeals in Epic, while supporting providers, staff, and patients.

You will process MSOT workflows, verify coverage and formulary alternatives, and document activity in Epic. This role requires strong communication and knowledge of insurance rules, with a focus on timely, accurate PA processing.

Qualifications

• High school education or equivalent.
• Licensed as a Pharmacy Technician or Pharmacist Intern in Michigan.
• 1 year Pharmacy Tech work experience.
• Understanding of commercial, Medicare, and Medicaid insurance plans.
• Familiarity with medical terminology, diagnosis codes, and PA criteria.
• Preferred: Proficiency with Epic and payer portals.
• Preferred: Experience with prior authorizations, insurance billing, or ambulatory pharmacy workflows.
• Preferred: Completion of a formal Pharmacy Technician training program; or two years of college with emphasis in math, science, or medical field applications.
• Preferred: Active status as a Certified Pharmacy Technician (CPhT) by the Pharmacy Technician Certification Board (PTCB)

Responsibilities

• Coordinate PA requests by reviewing payer requirements and gathering clinical information.
• Submit PA requests through payer portals, fax, or phone.
• Coordinate appeal submissions when necessary.
• Process Multi-Step Order Transmittal tasks and route statuses in MSOT workflows.
• Support providers and clinic staff with PA questions and documentation.
• Respond to PA-related questions from prescribers and clinic staff.
• Provide updates on PA status and timelines to patients.
• Verify insurance coverage, copays, and formulary alternatives.
• Document PA activity in Epic and MSOT task completion.
• Escalate only when clinical review is required.

Skills

Communication with prescribers and CL,

Medical terminology familiarity

Education

High school education or equivalent

Licensed as a Pharmacy Technician or Pharmacist Intern in Michigan

Formal Pharmacy Technician training program

Certified Pharmacy Technician (CPhT) by PTCB

Two years college in math/science/medical field

1 year Pharmacy Tech work experience

Tools

Epic EHR

Payer portals

Job description

Position Summary

The Prior Authorization Technician supports medication access by coordinating prior authorization (PA) requests, benefit investigations, and MSOT workflows within the Epic electronic health record. This role provides high-quality support to providers, office staff, and patients across multiple ambulatory clinics. The technician manages complex insurance requirements and serves as the primary point of contact for PA-related needs.

Employment Type

Full time

Shift

Day Shift

Description

Schedule | Hours:

• Full-time, 40 hours per week
• Days
• Monday-Friday

What You'll Do

• Prior authorization coordination
  • Review payer requirements, gather necessary clinical information, submit complete PA requests through payer portals, fax, or phone, and coordinate appeal submissions when necessary.
• MSOT workflow management
  • Process Multi-Step Order Transmittal tasks, ensure accurate internal routing, resolve workflow barriers, and communicate order status to clinic teams.
• Provider and office staff support
  • Respond to PA-related questions from prescribers and clinic staff.
  • Request additional documentation when needed.
  • Communicate approvals, denials, and alternative therapy requirements.
• Patient communication
  • Provide updates on PA status, expected timelines, and next steps; assist with understanding insurance requirements.
• Insurance benefit investigation
  • Verify coverage, copays, step therapy rules, and formulary alternatives.
• Documentation in Epic
  • Maintain accurate, timely notes in Epic, including PA status, payer communication, and MSOT task completion.
• Navigate denials, identify alternative pathways, and escalates only when clinical review is required.
• Ensure PA and MSOT tasks are completed efficiently and routed appropriately to support clinic operations.
• Prioritize and manage multiple concurrent PA and MSOT requests while meeting established turnaround time expectations.

What You'll Need

• High school education or equivalent.
• Licensed as a Pharmacy Technician or Pharmacist Intern in the State of Michigan.
• 1 year Pharmacy Tech Work experience.
• Understanding of commercial, Medicare, and Medicaid insurance plans.
• Familiarity with medical terminology, diagnosis codes, and PA criteria.
• Preferred: Proficiency with Epic and payer portals.
• Preferred: Experience with prior authorizations, insurance billing, or ambulatory pharmacy workflows.
• Preferred: Completion of a formal Pharmacy Technician training program; or two years of college with emphasis in math, science, or medical field applications.
• Preferred: Active status as a Certified Pharmacy Technician (CPhT) by the Pharmacy Technician Certification Board (PTCB)

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care.

We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.