Prior Authorization Pharmacy Technician - Massachusetts Pharmacy License

Shieldshealthsolutions; United States; Remote; USD 42,000 - 46,000; Full time

Job summary

Shields Health Solutions is seeking a Patient Support Advocate in Massachusetts to assist patients in accessing medications, navigating insurance, and coordinating financial assistance. The role involves supporting prior authorizations, eligibility reviews, and data entry within pharmacy systems to ensure timely therapy initiation.

You will collaborate with pharmacists and physicians to resolve coverage issues, document communications, and maintain accurate case records while promoting adherence

Qualifications

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

Responsibilities

• Communicate with insurance companies to facilitate medication approvals via prior authorizations.
• Assist patients in obtaining financial assistance through foundations and manufacturer programs.
• Navigate pharmacy systems to enter data, adjudicate claims, process refills, and create follow-up plans.

Skills

Customer service

Patient communication

Insurance claims

Pharmacy operations

Prior authorization

Data entry

Microsoft Office

Education

High School Diploma or GED

Tools

EMR systems

Microsoft Office

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

As a Patient Support Advocate, you will:

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

California residents employed by or applying for work at Shields have certain privacy rights. Please review our: California Workforce Privacy Notice and Privacy Policy.

By providing your mobile number, you agree to receive text messages from Shields Health Solutions related to job opportunities, interview scheduling, and recruiting updates. Message and data rates may apply. You may opt out at any time by replying 'STOP.' Consent is not a condition of employment.

Solid computer skills are required, including proficiency in Microsoft Office tools (Outlook, Teams, Word, Excel, and PowerPoint) for communication, documentation, and data management, as well as, navigating the internet and web-based platforms. Data entry and computer skills will be evaluated through an assessment as part of the pre-employment process.

Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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 [e-mail].