Prior Authorization Technician

American Oncology Partners, PA; United States; On-site; USD 26,077 - 43,477; Full time

Job summary

American Oncology Network AON is seeking a Pharmacy Technician to manage the authorization process for orders from clinics. You will perform prior authorizations, monitor each PA through to decision, and inform patients and clinics as appropriate.

Responsibilities include handling appeals, assisting clinicians with Celgene authorizations, and providing backup support to staff. Strong communication, detail orientation, and reliability are essential for success.

Qualifications

• High school diploma or GED required.
• Pharmacy technician registration with the Florida Dept of Health or applicable state licensure.
• Minimum two years’ experience in Retail/Specialty/Hospital Pharmacy as a Pharmacy Technician preferred.
• Medical terminology and attention to detail required.

Responsibilities

• Submit prior authorizations on behalf of physicians.
• Follow up on submitted PA requests and monitor through to approval/denial.
• Assist clinicians with Celgene authorization and confirmation numbers.
• Initiate and manage PA appeals with PMO/Medical Directors as needed.
• Provide backup support to pharmacy staff and arrange deliveries.

Skills

Prior authorizations

Appeals

Customer service

Communication

Remote work adaptability

MS Office

Education

High school diploma/GED

Pharmacy technician registration

Tools

MS Office Suite

Job description

Location: AON Pharmacy Pay Range: $18.93 - $31.56 Position Summary: The technician shall be responsible for the authorization process of orders coming into the Pharmacy from clinics

KPAs and Responsibilities

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/Requirements

Education: High school diploma, GED or equivalent education is required Previous Experience: Minimum of two years’ experience in Retail/Specialty/Hospital Pharmacy as a Pharmacy Technician preferred; medical terminology and attention to detail required.

Core Capabilities

Analysis & Critical Thinking: Critical thinking skills including solid problem solving, analysis, decision-making, planning, time management and organizational skills. Must be detailed oriented with the ability to exercise independent judgment. Interpersonal Effectiveness: Developed interpersonal skills, emotional intelligence, diplomacy, tact, conflict management, delegation skills, and diversity awareness. Ability to work effectively with sensitive and confidential material and sometimes emotionally charged matters. Communication Skills: Effective communication skills (oral, written, presentation), is an active listener, and effectively provides balanced feedback. Customer Service & Organizational Awareness: Strong customer focus. Ability to build an engaging culture of quality, performance effectiveness and operational excellence through best practices, strong business and political acumen, collaboration and partnerships, as well as a positive employee, physician and community relations. Self-Management: Effectively manages own time, conflicting priorities, self, stress, and professional development. Self-motivated and self-starter with ability work independently with limited supervision. Ability to work remotely effectively as required. Must be able to work effectively in a fast-paced, multi-site environment with demonstrated ability to juggle competing priorities and demands from a variety of stakeholders and sites. Computer Skills: Proficiency in MS Office Word, Excel, Power Point, and Outlook 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%

Standard Work Days/Hours

Monday to Friday 9:00 AM – 5:30 PM.

#AONA #LI-ONSITE

American Oncology Network AON is an alliance of physicians and veteran healthcare leaders dedicated to ensuring the long-term success and viability of oncology diagnosis and treatment in community-based settings. It is the fastest growing national network of community oncology practices delivering local access to exceptional cancer care. AON serves its expanding network of partner practices by providing proven practice management expertise. Our employees across the country work together to empower physicians to make cancer care better. By driving integrated, collaborative care, we are proudly helping community oncologists deliver the highest quality care to every patient. Cancer touches everyone. Being able to make a difference in the lives of those fighting this disease is something our employees at AON cherish and never take for granted. A career in oncology offers all sorts of rewards. But working at AON offers employees more than most. As a fast-growing national company, the opportunity to join a national workforce with flexible work options is available. We offer competitive compensation packages that include comprehensive health insurance with a robust provider network. Our 401k, which offers a 100% match and investment options, is available to full-time and part-time staff members, and we feature a generous Paid Time Off (PTO) program. At AON, we offer you more than a job, we offer you a career. As a network of independent oncology practices working together as one, we host annual summits each year, providing our employees a chance to collaborate with AON peers from across the country. Promoting from within is a priority at AON, and we support our team members continued growth through professional development programs and tuition assistance.