Prior Authorization Pharmacy Specialist
Methodist Le Bonheur Healthcare
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Job summary
Methodist Le Bonheur Healthcare in Memphis is seeking a Pharmacy Technician to handle precertification for prescription medications in inpatient and outpatient settings. You will verify that documentation supports insurer medical necessity and payment and collaborate with physicians and insurers to ensure timely approvals.
A strong hospital pharmacy background, EMR proficiency, and meticulous attention to detail are essential. This full-time role offers growth within a leading health system.
Qualifications
- High School Diploma or Equivalent.
- Pharmacy experience (clinical, hospital, outpatient, or specialty) 3-5 years.
- TN Pharmacy Technician license.
- Pharmacy Technician Certification Board certification.
- Preferred ExCPT certification.
- Preferred Mississippi Board of Pharmacy certification.
Responsibilities
- Precertification of eligible prescription medications for inpatient and outpatient services.
- Ensure documentation meets insurer medical necessity and payment guidelines.
- Review clinical information from providers to assess necessity and efficiency of use.
- Assist patient access with outpatient pharmacy coordination.
- Identify trends and root causes to improve processes.
Skills
Education
Tools
Job description
Methodist Le Bonheur Healthcare in Memphis is seeking a Pharmacy Technician to handle precertification for prescription medications in inpatient and outpatient settings. You will verify that documentation supports insurer medical necessity and payment and collaborate with physicians and insurers to ensure timely approvals.
A strong hospital pharmacy background, EMR proficiency, and meticulous attention to detail are essential. This full-time role offers growth within a leading health system.
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