Prior Authorization Coordinator

Cencora; Reading (Berks County); Hybrid; USD 42,000 - 65,000; Full time

Job summary

Cencora is seeking a Prior Authorization Coordinator to act as onsite triage for identified patients and prescriptions, facilitating authorization, reimbursement and dispensing of medications.

Located in Reading, PA with hybrid work options and a schedule of 8a-4:30p, Monday to Friday, this role supports a team delivering accessible health care and improved outcomes for patients and animals alike.

Qualifications

• Requires at least two years of related pharmacy experience.
• Pharmacy technician certification preferred or eligible for certification.

Responsibilities

• Prescription Processing: Master navigation of EMR and dispensing software system.
• Client Support: Provide excellent customer service to patients and healthcare professionals by answering inquiries, addressing pharmacy-related concerns, and triaging to pharmacist as appropriate.
• Benefits Investigation: Verify patient information and insurance coverage; resolve discrepancies with payers.
• Prior Authorization Completion: Gather documentation, complete forms, and communicate with providers and insurers to obtain approval.
• Communication: Demonstrate professionalism in all interactions and document patient information in the chart.
• Team Collaboration: Liaise between patient, pharmacy, and providers to ensure smooth workflow.
• Training: Participate in training of new staff.
• Program Continuity: Oversee continuity of processes and participate in quality improvement projects.
• Continuous Learning: Stay updated with developments and participate in training opportunities.
• Perform related duties as assigned

Skills

Communication skills

Independence

Interpersonal skills

Pharmacy terminology

Attention to detail

Prior authorization knowledge

Insurance verification

EHR familiarity

Education

Bachelor's degree preferred

PTCB certification preferred

Tools

Pharmacy software systems

Electronic Health Records (EHR)

Job description

Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and animals everywhere.

Job Details

The Prior Authorization Coordinator is a pharmacy technician who will act as onsite triage for identified patients and prescriptions, including specialty prescriptions, to facilitate authorization, reimbursement and dispensing of medications.

Location

Hybrid, Reading PA

Hours

8a-4:30p Monday to Friday

Responsibilities

• Prescription Processing: Master navigation of EMR and dispensing software system.
• Client Support: Provide excellent customer service to patients and healthcare professionals by answering inquiries, addressing pharmacy-related concerns, and triaging to pharmacist as appropriate. Manage multiple clinics with diverse needs autonomously.
• Benefits Investigation: Verify patient information and insurance coverage. Work with pharmacy team members and payers to resolve discrepancies and review insurance for affordability.
• Prior Authorization Completion: Demonstrate expertise with prior authorization process by gathering necessary documentation, completing forms, and communicating with healthcare providers and insurance companies to obtain approval for medications.
• Communication: Display professionalism in all interactions. Communicate effectively in‑person, via telephone, and in other electronic communication. Document pertinent patient information professionally and succinctly in patient chart, as agreed upon.
• Team Collaboration: Act as liaison between patient, pharmacy, and other healthcare providers to ensure smooth workflow and effective communication.
• Training: Participate in training of new staff.
• Program Continuity: Oversees continuity of pharmacy processes and adherence to clinical and specialty programs and policies. Participate in quality improvement projects, as deemed relevant and approved by manager.
• Continuous Learning: Stay updated with latest developments in practice area. Participate in training programs and continuing education opportunities to enhance knowledge and skills.
• Perform related duties as assigned

Education

Requires a minimum of two (2)+ years directly related and progressively responsible pharmacy experience; bachelor's degree program preferred. Pharmacy technician certification with a national technical certification organization, such as Pharmacy Technician Certification Board (PTCB) or other comparable national certification or comparable state certification is preferred.

Skills

Full technician licensure in the state of PA required.

• Ability to communicate professionally and effectively both orally and in writing
• Ability to work independently and as part of a team in a fast-paced environment.
• Exceptional interpersonal and communication skills, with ability to effectively address patient issues and collaborate with healthcare providers.
• Familiarity with pharmaceutical products, pharmaceutical terminology, and clinical pharmacy services
• Strong organizational skills; attention to detail
• Familiarity with prior authorization process and insurance verification.
• Good analytical skills.
• Commitment to maintaining patient confidentiality and privacy.
• Experience in using pharmacy software systems and electronic health records.

What Cencora offers

We provide compensation, benefits, and resources that enable a highly inclusive culture and support our team members’ ability to live with purpose every day. In addition to traditional offerings like medical, dental, and vision care, we also provide a comprehensive suite of benefits that focus on the physical, emotional, financial, and social aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, behavioral health solutions, paid parental leave, and paid caregiver leave. To encourage your personal growth, we also offer a variety of training programs, professional development resources, and opportunities to participate in mentorship programs, employee resource groups, volunteer activities, and much more. For details, visit https://www.virtualfairhub.com/cencora

Full time

Equal Employment Opportunity

Cencora is committed to providing equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, genetic information, national origin, age, disability, veteran status or membership in any other class protected by federal, state or local law. The company’s continued success depends on the full and effective utilization of qualified individuals. Therefore, harassment is prohibited and all matters related to recruiting, training, compensation, benefits, promotions and transfers comply with equal opportunity principles and are non-discriminatory. Cencora is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with legal requirements. If you wish to request an accommodation while seeking employment, please call 888.692.2272 or email [e-mail]. We will make accommodation determinations on a request-by-request basis. Messages and emails regarding anything other than accommodations requests will not be returned.

Affiliated Companies

Value Apothecaries Inc