Prior Authorization Technician

American Oncology Network, Inc.; Fort Myers (FL); Presencial; USD 22.000 - 42.000; Jornada completa

Descripción de la vacante

American Oncology Network, Inc. is seeking a Prior Authorization Technician to manage the authorization process for pharmacy orders from AON clinics in Fort Myers.

This onsite role includes handling prior authorizations, appeals, and staff training. The position requires a high school diploma, at least two years of relevant pharmacy technician experience, Florida DOH registration, and a valid driver's license for travel to satellite offices and meetings.

Formación

• High school diploma or GED required.
• Minimum of two years’ experience in Retail/Specialty/Hospital Pharmacy as a Pharmacy Technician preferred; medical terminology and attention to detail required.
• Pharmacy technician registration with the Florida Department of Health in good standing required; valid driver’s license for travel to satellite offices and offsite meetings.

Responsabilidades

• Submit prior authorizations on behalf of physicians and monitor each PA through the process to approval/denial.
• Review and initiate prior authorization appeals as needed; coordinate with Medical Directors and PBMs.
• Provide backup support to pharmacy staff, including PAP, SP follow-ups, BV and claims adjudication as needed.
• Stay current on training and permit maintenance; train staff on PA processes.

Educación

High school diploma or GED

Florida Pharmacy Technician Registration

Descripción del empleo

Location:

AON Pharmacy

Hiring Range:

$16.00 - $30.21

Position Summary

The Prior Authorization Technician shall be responsible for the authorization process of orders coming into the Pharmacy from AON clinics.

Key Performance Areas

KPA 1 – Prior and REMS Authorizations

• Submit prior authorizations on behalf of physicians
• Follow up on submitted PA requests when no response is received
• Monitor each PA through the process until approved/denied, and inform patient, staff and clinic as indicated.
• Responsible for assisting the clinicians in obtaining Celgene authorization and confirmation numbers.

KPA 2 – Appeals

• Will review and initiate prior authorization appeal services to include first level appeal reviews. Will coordinate appeal reviews with Medical Director(s) of pharmacy benefit managers and/or peer-to-peer interviews as required.

KPA 3 – Backup to pharmacy staff

• Will monitor daily activities and provide backup support where needed, including PAP, SP follow-ups, BV and claims adjudication as needed.

KPA 4 – Education & Training

• Responsible for keeping up on all applicable training and education for maintenance of permit.
• Will train staff on PA processes.

KPA 5 – Customer Service

• Incoming and outgoing calls/emails to patients. Routing of calls to appropriate staff. Answering patient/clinic questions regarding delivery status, Rx updates, etc.
• SP follow-up to assure orders are being processed efficiently.
• Scheduling deliveries.

Position Qualifications

Education

• High school diploma, GED or equivalent education is required

Minimum Relevant Experience

• Minimum of two years’ experience in Retail/Specialty/Hospital Pharmacy as a Pharmacy Technician preferred; medical terminology and attention to detail required.

Certifications/Licenses

• Pharmacy technician registration with the Florida Dept of Health in good standing required.
• Valid state Driver’s License for travel to satellite offices and offsite meetings. Compliance with the company Driver Safety Operations and Motor Vehicle Records Check Policy is required.

Travel : 0%

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