Prior Authorization Pharmacy Technician New

Shields Health Solutions; California, Northern (MO, KY); Presencial; USD 28 000 - 30 000; Tempo integral

Resumo da oferta

Shields Health Solutions is seeking a Patient Support Advocate to help patients access medications and navigate insurance, financial assistance, and pharmacy operations. The role emphasizes patient advocacy and collaboration with physicians and pharmacists to ensure timely therapy.

You will support prior authorizations, assist with financial assistance coordination, and maintain accurate documentation across systems. Travel may be required occasionally.

Qualificações

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

Responsabilidades

• 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.
• Document patient concerns, prior authorizations, and financial assistance needs across databases and EMR systems.
• Collaborate with physicians' offices to ensure timely medication therapy and patient safety.
• Maintain accurate records of patient communications and case activity.
• Assist patients with managing insurance claims and resolving coverage issues.
• Coordinate with pharmacists and liaisons to deliver coordinated patient care.
• Provide phone support to improve medication adherence and compliance.

Conhecimentos

Customer service

Patient communication

Insurance claims handling

Prior authorizations

Pharmacy operations

Formação académica

High School Diploma or GED

Ferramentas

Pharmacy software systems

EMR/EHR

Microsoft Office

Descrição da oferta de emprego

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:

• 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

Keywords

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].

WOTC Applicant Survey: Shields Heath Solutions is participating in the Work Opportunity Tax Credit (WOTC) program. This program is designed by the federal government to help companies with federal incentives for hiring and retaining individuals from certain targeted groups into the workforce.Your preliminary response to the IRS Form 8850 questions below will help determine if Shields Health Solutions qualifies for this program. Any information you provide will be kept confidential and will not negatively affect your job, wages, or taxes. Thank you in advance for your time and participation.In order to determine if Shields Health Solutions potentially qualifies for this program, please check the box, at your discretion, if any of the statements below apply to you. I received a conditional certification from the state workforce agency (SWA) or a participating local agency for the work opportunity credit. If any of the following statements apply to you. I am a member of a family that has received assistance from Temporary Assistance for Needy Families (TANF) for any 9 months during the past 18 months. I am a veteran and a member of a family that received Supplemental Nutrition Assistance Program (SNAP) benefits (food stamps) for at least a 3-month period during the past 15 months. I was referred here by a rehabilitation agency approved by the state, an employment network under the Ticket to Work program, or the Department of Veteran Affairs. I am at least age 18 but not age 40 or older and I am a member of a family that:a. Received SNAP benefits (food stamps) for the past 6 months, orb. Received SNAP benefits (food stamps) for at least 3 of the past 5 months, but is no longer eligible to receive them. I received supplement security income (SSI) benefits for any month ending during the past 60 days. I am a veteran and I was unemployed for a period or periods totaling at least 4 weeks but less than 6 months during the past year. I am a veteran and was unemployed for a period or periods totaling at least 6 months during the past year. I am a veteran entitled to compensation for a service-connected disability and I was discharged or released from active duty in the U.S. Armed Forces during the past year. I am a veteran entitled to compensation for a service-connected disability and I was unemployed for a period or periods totaling at least 6 months during the past year. I am a member of a family that: Received TANF payments for at least the past 18 months, or Received TANF payments for any 18 months beginning after August 5, 1997, and the earliest18-month period beginning after August 5, 1997, ended during the past 2 years, or Stopped being eligible for TANF payments during the past 2 years because federal or state law limited the maximum time those payments could be made. I have been unemployed at least 27 consecutive weeks and for all or part of that period I received unemployment compensation. (v.27) * Select...

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