Prior Authorization Pharmacy Tech: Coverage and Coordination

Medix Staffing Solutions, Inc.; Maryland; On-site; USD 52,000 - 72,000; Full time

Benefits offered by this job

Paid Sick Leave

Health Benefits

Dental & Vision Insurance

401k Plan

Short Term Disability

Term Life Insurance

Job summary

Medix Staffing Solutions, Inc. is seeking a Prior Authorization Pharmacy Technician to evaluate and determine coverage for prior authorization requests, ensure decisions align with clinical criteria and plan guidelines.

You will coordinate with providers, pharmacies, and members, document case details, and support appeals while maintaining compliance with regulatory standards and plan policies.

Qualifications

• Active pharmacy technician license.
• Knowledge of prior authorization processes and insurance benefit guidelines.
• Strong attention to detail and documentation accuracy.
• Excellent communication and problem-solving abilities.
• Ability to manage multiple priorities in a fast-paced environment.

Responsibilities

• Evaluate and determine PA coverage using clinical criteria and plan guidelines.
• Coordinate with providers, pharmacies, and members to gather documentation.
• Maintain complete records of PA requests, renewals, determinations, and follow-ups.
• Support appeals and administrative workflow for efficient operations.
• Adhere to regulatory standards and identify process improvements.

Skills

PA platforms

pharmacy claims processing

formulary structures

communication

Education

Pharmacy Technician Certification

Tools

Pharmacy PA platforms

Job description

Medix Staffing Solutions, Inc. is seeking a Prior Authorization Pharmacy Technician to evaluate and determine coverage for prior authorization requests, ensure decisions align with clinical criteria and plan guidelines.

You will coordinate with providers, pharmacies, and members, document case details, and support appeals while maintaining compliance with regulatory standards and plan policies.