Prior Authorization Pharmacy Tech - Epic/MSOT Focus

IHA; Grand Rapids (MI); On-site; USD 42,000 - 56,000; Full time

Job summary

IHA is seeking a Prior Authorization Technician to coordinate PA requests across multiple ambulatory clinics in Michigan. You will manage payer requirements, submit PA requests, and coordinate appeals in Epic, while supporting providers, staff, and patients.

You will process MSOT workflows, verify coverage and formulary alternatives, and document activity in Epic. This role requires strong communication and knowledge of insurance rules, with a focus on timely, accurate PA processing.

Qualifications

• High school education or equivalent.
• Licensed as a Pharmacy Technician or Pharmacist Intern in Michigan.
• 1 year Pharmacy Tech work experience.
• Understanding of commercial, Medicare, and Medicaid insurance plans.
• Familiarity with medical terminology, diagnosis codes, and PA criteria.
• Preferred: Proficiency with Epic and payer portals.
• Preferred: Experience with prior authorizations, insurance billing, or ambulatory pharmacy workflows.
• Preferred: Completion of a formal Pharmacy Technician training program; or two years of college with emphasis in math, science, or medical field applications.
• Preferred: Active status as a Certified Pharmacy Technician (CPhT) by the Pharmacy Technician Certification Board (PTCB)

Responsibilities

• Coordinate PA requests by reviewing payer requirements and gathering clinical information.
• Submit PA requests through payer portals, fax, or phone.
• Coordinate appeal submissions when necessary.
• Process Multi-Step Order Transmittal tasks and route statuses in MSOT workflows.
• Support providers and clinic staff with PA questions and documentation.
• Respond to PA-related questions from prescribers and clinic staff.
• Provide updates on PA status and timelines to patients.
• Verify insurance coverage, copays, and formulary alternatives.
• Document PA activity in Epic and MSOT task completion.
• Escalate only when clinical review is required.

Skills

Communication with prescribers and CL,

Medical terminology familiarity

Education

High school education or equivalent

Licensed as a Pharmacy Technician or Pharmacist Intern in Michigan

Formal Pharmacy Technician training program

Certified Pharmacy Technician (CPhT) by PTCB

Two years college in math/science/medical field

1 year Pharmacy Tech work experience

Tools

Epic EHR

Payer portals

Job description

IHA is seeking a Prior Authorization Technician to coordinate PA requests across multiple ambulatory clinics in Michigan. You will manage payer requirements, submit PA requests, and coordinate appeals in Epic, while supporting providers, staff, and patients.

You will process MSOT workflows, verify coverage and formulary alternatives, and document activity in Epic. This role requires strong communication and knowledge of insurance rules, with a focus on timely, accurate PA processing.