Prior Authorization Pharmacy Tech - Patient Access

Chaparral Medical Group; Pomona (CA); On-site; USD 39,000 - 44,000; Full time

Job summary

Chaparral Medical Group in Pomona, CA is seeking a Pharmacy Technician – Prior Authorization Specialist to manage medication prior authorizations across our clinics. This role serves as a liaison between providers, patients, pharmacies, and insurers to secure timely approvals and maintain continuity of care.

The ideal candidate will review clinical documentation, submit requests via payer portals, monitor cases, and communicate outcomes.

Qualifications

• High school diploma or equivalent required.
• Active Pharmacy Technician registration, license, or certification as required by state regulations.
• Minimum of one year of experience as a Pharmacy Technician or related healthcare role.
• Experience processing medication prior authorizations and working with commercial, Medicare, and Medicaid insurance plans.
• Knowledge of pharmacy terminology, medication classifications, and insurance benefit structures.
• Experience utilizing electronic health records (EHR) and payer authorization portals.
• Strong organizational, analytical, and problem-solving skills.
• Excellent verbal and written communication skills.

Responsibilities

• Serve as the primary resource for medication prior authorization processes across all clinics.
• Manage a high-volume authorization workload while maintaining quality and accuracy standards.
• Review insurance eligibility, pharmacy benefits, and formulary requirements.
• Coordinate peer-to-peer review requests and appeal submissions when necessary.
• Maintain knowledge of payer-specific authorization requirements and medication coverage policies.
• Partner with providers and clinical leadership to improve authorization workflows and reduce delays in patient care.
• Monitor authorization metrics and contribute to process improvement initiatives.
• Provide exceptional customer service to patients by addressing medication access concerns and providing timely updates.
• Participate in department meetings, training programs, and organizational projects as assigned.
• Support compliance efforts by ensuring complete and accurate documentation of authorization activities.

Skills

Communication

Organizational

Analytical thinking

Multitasking

Problem solving

EHR experience

Education

High school diploma

Pharmacy Technician registration/certification

Tools

EHR systems

Payer portals

Microsoft Office

Job description

Chaparral Medical Group in Pomona, CA is seeking a Pharmacy Technician – Prior Authorization Specialist to manage medication prior authorizations across our clinics. This role serves as a liaison between providers, patients, pharmacies, and insurers to secure timely approvals and maintain continuity of care.

The ideal candidate will review clinical documentation, submit requests via payer portals, monitor cases, and communicate outcomes.