Prior Authorization Pharmacy Technician

Insight Global; United States; Remote; USD 28,000 - 30,000; Full time

Benefits offered by this job

Bonuses available

Benefits starting day one

401(k) eligibility

Paid time off

Job summary

Insight Global is seeking Prior Authorization Technicians to work fully remote for a major healthcare client. You will support patient care by removing barriers to medication access, liaising with insurance companies and clinicians to obtain approvals, and assisting with financial assistance navigation.

The role includes handling pharmacy systems, inputting data, adjudicating claims, processing refills, and promoting adherence.

Qualifications

• Communicate directly with insurance companies to facilitate medication approvals.
• Navigate pharmacy operating systems to input data, adjudicate test claims, and develop action plans for follow-up.
• Document patient concerns, prior authorization status, and financial assistance needs across databases and EMR systems.

Responsibilities

• Communicate with insurers to facilitate approvals.
• Input data in pharmacy systems and adjudicate claims.
• Document patient concerns and authorization status across EMR systems.
• Review prescriptions with physicians to ensure patient care quality.
• Maintain records of patient communications.
• Assist patients with managing insurance claims.

Skills

Insurance communications

Data entry

Customer service

Phone support

Confidentiality

Tools

Pharmacy software

EMR systems

Job description

Insight Global is looking for Prior Authorization Technicians to work fully remote in support of one of our large healthcare clients. In this role, the individual will support patient care by removing barriers to medication access. This includes working with insurance companies and clinician offices to facilitate medication approvals through prior authorizations, as well as collaborating with patients and various funding sources, such as foundations or pharmaceutical manufacturers, to obtain financial assistance for high-cost copays. The role also involves providing phone support to patients, navigating pharmacy dispensing systems to adjudicate claims, process refills, and promoting medication adherence.

Job Duties:

• Communicate directly with insurance companies to facilitate medication approvals.
• Navigate pharmacy operating systems to input data, adjudicate test claims, and develop action plans for follow-up.
• Communicate effectively across databases, electronic medical records, and email systems to document patient concerns, prior authorization status, and financial assistance needs.
• Review prescriptions with physicians’ offices to ensure optimal patient care.
• Maintain complete and accurate records of patient communications.
• Assist patients with managing their pharmacy insurance claims.
• Collaborate closely with pharmacists and pharmacy liaisons to deliver a coordinated, high-quality patient care experience.
• Communicate directly with patients via phone to support medication adherence and compliance.
• Research and analyze information to support strategic decision-making.
• Manage, organize, and update relevant data within database systems.
• Apply observations and recommendations to improve operations, productivity, quality, and customer service standards.
• Identify trends, resolve issues, recommend improvements, and implement changes.
• Participate actively in process improvement initiatives.
• Act as a value-added business partner to stakeholders across the organization.
• Protect organizational value by maintaining confidentiality of information.
• Maintain professional knowledge by participating in educational opportunities, reading professional publications, and engaging in professional networks and organizations.
• Minimal in-state or out-of-state travel may be required.
• Perform other duties as assigned.

Hourly Pay Range:

$20/hr-$22/hr based on experience. (BONUSES AVAILABLE)

Exact compensation may vary based on several factors, including skills, experience, and education.

Employees in this role will enjoy a comprehensive benefits package starting on day one of employment, including options for medical, dental, and vision insurance. Eligibility to enroll in the 401(k) retirement plan begins after 90 days of employment. Additionally, employees in this role will have access to paid sick leave and other paid time off benefits as required under the applicable law of the worksite location.