Prior Authorization Pharmacy Technician - Massachusetts Pharmacy License New

Shields Health Solutions; Northern (KY); Hybrid; USD 28,000 - 30,000; Full time

Job summary

Shields Health Solutions is seeking an experienced Pharmacy Technician to act as a Patient Support Advocate, aiding patients with prior authorizations, insurance navigation, and financial assistance while supporting pharmacy operations. This remote role emphasizes patient access and adherence, collaborating with physicians and pharmacists to ensure timely therapy.

The position requires MA licensure consideration and a focus on privacy and compliance, with opportunities to impact patient outcomes

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 prior authorizations.
• Help patients access financial assistance through foundations and manufacturer programs.
• Enter data, adjudicate claims, process refills, and create follow-up action plans in pharmacy systems.
• Document patient concerns, prior authorization status, and financial needs across databases and EMR.
• Collaborate with physicians' offices to ensure timely medication therapy.
• Maintain complete records of patient communications and case activity.
• Assist with managing insurance claims and resolve coverage-related issues.
• Partner with pharmacists and liaisons to deliver coordinated patient care.
• Provide phone support to improve medication adherence.
• Research and analyze information to support decision-making and problem resolution.
• Manage data within various database applications.
• Identify trends and contribute to process improvements.

Skills

Customer service

Insurance claims

Prior authorizations

Pharmacy operations

Data entry

Communication

Education

High School Diploma or GED

Tools

Pharmacy software

Job description

Prior Authorization Pharmacy Technician - Massachusetts Pharmacy License

Remote

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.

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
• Education
• Skills and abilities
• Certifications and licensure
• Other job-related qualifications

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].