Prior Authorization Certified Pharmacy Technician

Shields Health Solutions; Cleveland (OH); Remote; USD 2,679,000 - 3,060,000; Full time

Job summary

Shields Health Solutions is seeking a Patient Support Advocate to assist patients in navigating insurance, prior authorizations, and financial assistance to access prescribed therapies. The role leverages pharmacy knowledge and strong communication to improve medication adherence and outcomes.

As a Pharmacy Technician-focused position, you will work remotely, support patients by phone, and collaborate with healthcare providers while ensuring compliance with licensure requirements and privacy

Qualifications

• Minimum 1+ year of Pharmacy Technician experience.
• High School Diploma or GED required.
• State registration or certification as a Pharmacy Technician where applicable; national certification (CPhT) required at hire.

Responsibilities

• Facilitate medication approvals with insurance and prior authorizations.
• Enter data in pharmacy systems, adjudicate claims, and follow up as needed.
• Document patient communications across EMRs and databases.
• Collaborate with physicians and pharmacists to ensure access to prescribed therapies.

Skills

Pharmacy Technician

Customer service

Communication

Education

High School Diploma or GED

Tools

EMR systems

Pharmacy software

Microsoft Office

Job description

Remote

Help Patients Access the Medications They Need—When They Need Them Most

Are you a Pharmacy Technician who is passionate about patient care, medication access, and making a meaningful difference in patients' lives? Join our team as a Patient Support Advocate, where you'll serve as a trusted resource for patients, providers, insurance companies, and financial assistance programs to help remove barriers to treatment and improve medication adherence.

In this rewarding role, you'll combine your pharmacy knowledge, insurance expertise, and patient advocacy skills to help patients navigate complex healthcare systems and gain access to life-changing medications.

What You'll Do

• Communicate directly with insurance companies to facilitate medication approvals and prior authorizations.
• Navigate pharmacy operating systems to enter data, adjudicate test claims, and develop follow-up action plans.
• Document patient concerns, prior authorization status, and financial assistance needs across multiple databases, electronic medical records (EMRs), and email platforms.
• Collaborate with physicians' offices to ensure patients receive optimal care and access to prescribed therapies.
• Maintain complete and accurate records of all patient communications and case activity.
• Assist patients with pharmacy insurance claims and medication access challenges.
• Partner closely with pharmacists and pharmacy liaisons to deliver an integrated, high-quality patient care experience.
• Provide compassionate phone support to patients, helping them manage refills, medication adherence, and pharmacy-related questions.
• Research and investigate information to support informed decision-making and patient outcomes.
• Manage, organize, and update data using various database applications.
• Identify operational opportunities, recommend improvements, and support enhanced productivity, quality, and customer service standards.
• Analyze trends, resolve issues, implement solutions, and contribute to continuous process improvement initiatives.
• Serve as a value-added business partner to stakeholders throughout the organization.
• Protect confidential patient and organizational information in accordance with company policies.
• Stay current with industry trends and best practices through continuing education, professional publications, networking, and professional organizations.
• Perform other duties as assigned.

Minimal in-state or out-of-state travel may be required.

What Success Looks Like

The ideal candidate is:

• Patient-focused and compassionate
• Detail-oriented with strong organizational skills
• Comfortable navigating multiple technology platforms and pharmacy systems
• Experienced in pharmacy insurance, prior authorizations, and financial assistance processes
• An effective communicator who excels in phone-based patient support
• A collaborative team player who enjoys solving complex problems

Required Experience

• Minimum 1+ year of Pharmacy Technician experience

Education

• High School Diploma or GED required

Licensure & Certification

We are seeking experienced Pharmacy Technicians who are:

• State registered or state certified as a Pharmacy Technician, where applicable
• National certification (CPhT or equivalent) required

If the candidate's state of residence does not offer Pharmacy Technician registration, national certification is required at the time of hire.

Should additional licensure be necessary, the selected candidate must obtain the required credential(s) within a mutually agreed-upon timeframe. Continued employment is contingent upon maintaining required licensure and certification standards.

Shields Health Solutions is committed to pay transparency and equal employment opportunities.

Hourly Pay Range:
$19.45 - $22.21 per hour

Actual compensation may vary based on factors including, but not limited to:

• Geographic location
• Skills and abilities
• Education
• Certifications and licensure
• Other job-related considerations

Why This Role Matters

Every day, patients face challenges accessing essential medications due to insurance requirements, high out-of-pocket costs, and healthcare system complexities. As a Patient Support Advocate, you'll play a vital role in helping patients overcome these barriers, stay on therapy and achieve better health outcomes.

SEO Keywords Naturally Embedded

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By providing your mobile number, you agree to receive text messages from Shields Health Solutions related to job opportunities, interview scheduling, and recruiting updates. Message and data rates may apply. You may opt out at any time by replying 'STOP.' Consent is not a condition of employment.

Solid computer skills are required, including proficiency in Microsoft Office tools (Outlook, Teams, Word, Excel, and PowerPoint) for communication, documentation, and data management, as well as, navigating the internet and web-based platforms. Data entry and computer skills will be evaluated through an assessment as part of the pre-employment process.

Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Shields Health Solutions is committed to providing an inclusive hiring experience; if you need assistance or accommodation during the application or interview process, please email [e-mail].

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