Prior Authorization Technician

American Oncology Management Company; Fort Myers (FL); Híbrido; USD 22.000 - 42.000; Jornada completa

Descripción de la vacante

American Oncology Management Company is seeking a Prior Authorization Technician to manage PA orders from AON clinics, follow up on submissions, and guide the process to approval or denial. The role includes assisting with Celgene authorizations, and coordinating appeals with medical directors. It also provides backup support and customer service to patients and clinics while training staff on PA workflows.

Formación

• High school diploma or GED required.
• Minimum of two years' experience as a Pharmacy Technician in Retail/Specialty/Hospital Pharmacy; attention to detail essential.
• Pharmacy technician registration with Florida Department of Health in good standing required.
• Valid state Driver's License for travel to satellite offices and offsite meetings; comply with safety policies.

Responsabilidades

• Submit prior authorizations on behalf of physicians.
• Follow up on PA requests when no response is received.
• Monitor each PA through the process and inform patient, staff and clinic of status.
• Assist clinicians with Celgene authorization and confirmation numbers.
• Review and initiate prior authorization appeals with Medical Directors and related personnel.
• Provide backup to pharmacy staff for PAP, SP follow-ups, BV and claims adjudication as needed.
• Educate staff on PA processes.

Conocimientos

Pharmacy Technician Experience

Attention to detail

Medical terminology

Customer service

Educación

High school diploma / GED

Herramientas

Florida Pharmacy Technician Registration (DOH)

Driver's License

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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