Prior Authorization & Medication Access Technician

Shields Health Solutions; Bristol (RI); On-site; USD 28,000 - 30,000; Full time

Job summary

Shields Health Solutions seeks an experienced Pharmacy Technician to join our Rhode Island operations as a Patient Support Advocate. You’ll help patients access medications, navigate insurance, coordinate financial assistance, and support prior authorizations in a collaborative pharmacy team.

This role emphasizes data entry, claims adjudication, and patient communication, with a focus on adherence and access.

Qualifications

• Minimum 1 year of Pharmacy Technician experience.
• Rhode Island State Registered and/or State Certified Pharmacy Technicians (where applicable).
• National certification is required at time of hire if the state residence does not offer pharmacist registration.

Responsibilities

• Communicate directly with insurance companies to facilitate medication approvals through prior authorizations.
• Help patients access financial assistance through foundations, manufacturer programs, and other funding resources to reduce high-cost medication burdens.
• Navigate pharmacy operating systems to enter data, adjudicate claims, process refills, and create follow-up action plans.
• Document patient concerns, prior authorization status updates, and financial assistance needs across databases, EMR, and email systems.
• Assist patients in managing pharmacy insurance claims and resolving coverage-related issues.
• Partner with pharmacists and pharmacy liaisons to deliver coordinated, high-quality patient care.
• Provide phone support to patients to improve medication adherence and compliance.
• Research, investigate, and analyze information to support decision-making and problem resolution.
• Manage, organize, and maintain data within various database applications.
• Identify trends, recommend process improvements, and contribute to operational excellence initiatives.
• Protect confidential information and maintain compliance with privacy requirements.
• Remain current on industry knowledge through continuing education and networking.

Skills

Customer service

Patient communication

Insurance claims

Prior authorization

Pharmacy operations

Education

High School Diploma or GED

Tools

Microsoft Office

Job description

Shields Health Solutions seeks an experienced Pharmacy Technician to join our Rhode Island operations as a Patient Support Advocate. You’ll help patients access medications, navigate insurance, coordinate financial assistance, and support prior authorizations in a collaborative pharmacy team.

This role emphasizes data entry, claims adjudication, and patient communication, with a focus on adherence and access.