Prior Authorization Pharmacy Specialist — Care Navigator

Akido; Ontario (CA); On-site; USD 42,000 - 65,000; Full time

Job summary

Akido in the United States is seeking a Pharmacy Technician – Prior Authorization Specialist to oversee medication prior authorization requests across all clinics. This role serves as a critical liaison between providers, patients, pharmacies, insurers and staff to ensure timely approvals and continuity of care.

The Pharmacy Technician will review authorization requirements, gather clinical documentation, submit requests, monitor cases, and communicate outcomes to key stakeholders.

Qualifications

• Experience as Pharmacy Technician with knowledge of pharmacy benefits management (PBM) processes.
• Ability to review patient charts and clinical documentation for completeness.
• Experience submitting prior authorization requests through payer portals and electronic systems.

Responsibilities

• Process medication prior authorization requests across all clinics.
• Review patient charts and documentation prior to submission.
• Collaborate with providers, MAs, nurses, and clinic staff to obtain supporting information.
• Submit authorization requests through payer portals, electronic systems, fax, or phone.
• Monitor authorization status and follow up with insurers to expedite approvals.
• Communicate determinations, denials, and appeals requirements to providers and clinic teams.
• Maintain accurate documentation of authorization activities in the EHR.
• Track turnaround times and identify barriers to medication access.
• Assist in resolving coverage issues and consider formulary alternatives when appropriate.
• Ensure compliance with regulatory requirements and insurer guidelines.

Skills

Attention to detail

Communication skills

PBM knowledge

Healthcare teamwork

Job description

Akido in the United States is seeking a Pharmacy Technician – Prior Authorization Specialist to oversee medication prior authorization requests across all clinics. This role serves as a critical liaison between providers, patients, pharmacies, insurers and staff to ensure timely approvals and continuity of care.

The Pharmacy Technician will review authorization requirements, gather clinical documentation, submit requests, monitor cases, and communicate outcomes to key stakeholders.