Prior Authorization - Pharmacy Technician

Healthcare Support Staffing; Philadelphia (Philadelphia County); On-site; USD 40,000 - 50,000; Full time

Job summary

A leading healthcare staffing firm in Philadelphia seeks an experienced Pharmacy Technician. The role involves assisting with the prior authorization process, maintaining databases, and ensuring compliance with pharmacy standards. Candidates should have a PTCB pharmacy certification and a high school diploma or GED, with at least 2 years of pharmacy experience required. This is an opportunity to grow and advance in your pharmacy career in a supportive environment.

Qualifications

• Minimum 2 years’ pharmacy experience.

Responsibilities

• Assist in the prior authorization process for pharmacy.
• Review physician inquiries for pre-authorization and medical necessity.
• Support Fraud and Abuse program system oversight.
• Maintain and update internal databases and generate reports.
• Create a teamwork environment and maintain communication.
• Perform related duties as assigned.
• Attend required training annually.

Skills

PTCB pharmacy certifications

Typing speed of 35 wpm

Education

HS Diploma or GED

Job description

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Under the general supervision of the Supervisor of Pharmacy Prior Authorization Technicians, the Pharm Techs here will assists in the prior authorization process.

• Reviews and approves physician inquiries for pre-authorization and medical necessity requests based on established pharmacy guidelines and contract criteria.
• Supports Fraud and Abuse program system oversight by reviewing medication utilization records. Communicates any suspected fraud discovered. Recommends course of action for providers where patterns appears outside of guidelines and generally accepted pharmacy standards.
• Keeps abreast of industry trends and regulatory changes in the pharmacy industry and incorporates knowledge in the performance of job duties. Identifies problems in process/procedures or services and makes recommendations for improvements. Maintains a balance of productivity, quality and timeliness of job accountabilities. Participates in department self-audit procedures for on-going evaluation of service.
• Maintains and updates internal databases. Enters application information, prior authorizations and other relevant data. Ensures database information and appended files are current and accessible to staff. Generates reports and other information requested on a scheduled/as needed basis.
• Creates and supports an environment which fosters teamwork, cooperation, respect and diversity. Establishes and maintains positive communication and professional demeanor with AMFC employees and clients at all times.
• Performs other related duties as assigned.
• Attends required training on an annual basis.

Qualifications

• Must have PTCB pharmacy certifications
• HS Diploma or GED
• Minimum 2 years’ pharmacy experience
• Ability to type 35 wpm

Additional Information

Are you an experienced Certified Pharmacy Technician looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career as a Pharmacy Technician by joining a rapidly growing company? If you answered “yes" to any of these questions – this Pharmacy Technician is for you!

If you are interested, Please Contact Hannah Barreta at 321-710-4797 by replying to this job post.