Prior Authorization & Appeals Specialist

American Oncology Management Company; Fort Myers (FL); Hybrid; USD 22,000 - 42,000; Full time

Job summary

American Oncology Management Company is seeking a Prior Authorization Technician to manage PA orders from AON clinics, follow up on submissions, and guide the process to approval or denial. The role includes assisting with Celgene authorizations, and coordinating appeals with medical directors. It also provides backup support and customer service to patients and clinics while training staff on PA workflows.

Qualifications

• High school diploma or GED required.
• Minimum of two years' experience as a Pharmacy Technician in Retail/Specialty/Hospital Pharmacy; attention to detail essential.
• Pharmacy technician registration with Florida Department of Health in good standing required.
• Valid state Driver's License for travel to satellite offices and offsite meetings; comply with safety policies.

Responsibilities

• Submit prior authorizations on behalf of physicians.
• Follow up on PA requests when no response is received.
• Monitor each PA through the process and inform patient, staff and clinic of status.
• Assist clinicians with Celgene authorization and confirmation numbers.
• Review and initiate prior authorization appeals with Medical Directors and related personnel.
• Provide backup to pharmacy staff for PAP, SP follow-ups, BV and claims adjudication as needed.
• Educate staff on PA processes.

Skills

Pharmacy Technician Experience

Attention to detail

Medical terminology

Customer service

Education

High school diploma / GED

Tools

Florida Pharmacy Technician Registration (DOH)

Driver's License

Job description

American Oncology Management Company is seeking a Prior Authorization Technician to manage PA orders from AON clinics, follow up on submissions, and guide the process to approval or denial. The role includes assisting with Celgene authorizations, and coordinating appeals with medical directors. It also provides backup support and customer service to patients and clinics while training staff on PA workflows.