Prior Authorization Pharmacy Technician - Massachusetts Pharmacy License

Shields Health Solutions; Boston (MA); On-site; USD 57,308,000 - 63,039,000; Full time

Job summary

Shields Health Solutions seeks a Patient Support Advocate with Massachusetts-licensed pharmacy technician credentials to help patients gain access to medications and navigate insurance and financial assistance challenges.

The role includes prior authorizations, data entry, claims adjudication, and collaborating with pharmacists and physicians to ensure timely therapy and adherence. Requires MA registration and strong patient service skills; salary is hourly and commensurate with experience.

Qualifications

• Minimum 1 year of Pharmacy Technician experience.
• Strong customer service and patient communication skills.
• Experience with insurance claims or prior authorizations is preferred.

Responsibilities

• Communicate with insurance companies to obtain prior authorizations.
• Assist patients in navigating financial assistance programs and foundations.
• Enter data, adjudicate claims, process refills, and manage follow-up actions in systems.
• Document patient concerns and status updates across databases and EMR systems.
• Collaborate with physicians' offices to ensure timely medication therapy and coordination.

Skills

Pharmacy Technician experience

Customer service

Insurance claims

Pharmacy operations

Education

High School Diploma or GED

Job description

Patient Support Advocate - Massachusetts Licensed Pharmacy Technician

Help Patients Access the Medications They Need

Are you an experienced Pharmacy Technician who is passionate about helping patients overcome barriers to care? Join our team as a Patient Support Advocate, where you'll play a critical role in improving medication access, supporting adherence, and guiding patients through insurance and financial assistance challenges. This position combines patient advocacy, prior authorization support, insurance navigation, financial assistance coordination, and pharmacy operations, making a direct impact on patient outcomes every day.

What You’ll Do

• Communicate directly with insurance companies to facilitate medication approvals through prior authorizations.
• Help patients access financial assistance through foundations, manufacturer programs, and other funding resources to reduce high-cost medication burdens.
• Navigate pharmacy operating systems to enter data, adjudicate claims, process refills, and create follow-up action plans.
• Document patient concerns, prior authorization status updates, and financial assistance needs across databases, electronic medical records, and email systems.
• Collaborate with physicians' offices to ensure patients receive timely and appropriate medication therapy.
• Maintain complete and accurate records of patient communications and case activity.
• Assist patients in managing pharmacy insurance claims and resolving coverage-related issues.
• Partner closely with pharmacists and pharmacy liaisons to deliver coordinated, high-quality patient care.
• Provide phone support to patients and help improve medication adherence and compliance.
• Research, investigate, and analyze information to support decision-making and problem resolution.
• Manage, organize, and maintain data within various database applications.
• Identify trends, recommend process improvements, and contribute to operational excellence initiatives.
• Serve as a trusted business partner to stakeholders throughout the organization.
• Protect confidential information and maintain compliance with all privacy requirements.
• Remain current on industry knowledge through continuing education, professional publications, and networking opportunities.
• Travel occasionally, as business needs require.
• Perform other duties as assigned.

What We’re Looking For

Required Experience

• Minimum 1 year of Pharmacy Technician experience
• Strong customer service and patient communication skills
• Experience working with insurance claims, medication access, prior authorizations, or pharmacy operations preferred

Education

High School Diploma or GED required.

Licensure & Certification

We are seeking experienced Pharmacy Technicians who are:

• Massachusetts State Registered and/or State Certified Pharmacy Technicians (where applicable)
• National certification (CPhT or equivalent) is strongly preferred but not required

Important: If the candidate's state of residence does not offer pharmacy technician registration, national certification is required at the time of hire. Should additional licensure be required, the candidate must obtain the necessary credentials within a mutually agreed-upon timeframe. Continued employment is contingent upon maintaining required licensure and certification requirements.

Why This Role Matters

Every day, you'll help patients navigate complex insurance requirements, secure financial assistance, and gain access to life-changing medications. Your work will directly support better health outcomes while delivering an exceptional patient experience.

Compensation & Benefits

At Shields Health Solutions, we are committed to pay transparency and equal employment opportunities.

Hourly Pay Range: $20.00 - $22.00 per hour.

Actual compensation may vary based on several factors, including:

• Geographic location
• Relevant experience
• Education
• Skills and abilities
• Certifications and licensure
• Other job-related qualifications

Keywords

• Pharmacy Technician
• Certified Pharmacy Technician (CPhT)
• Patient Support Advocate
• Prior Authorization Specialist
• Medication Access
• Specialty Pharmacy
• Patient Assistance Programs
• Insurance Verification
• Claims Adjudication
• Financial Assistance
• Pharmacy Operations
• Healthcare Support
• Medication Adherence
• Patient Advocacy

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Shields Health Solutions is committed to providing an inclusive hiring experience; if you need assistance or accommodation during the application or interview process, please email .