Specialty Pharmacy Preauthorization Specialist

Methodist Le Bonheur Healthcare; Memphis (TN); On-site; USD 34,000 - 52,000; Full time

Job summary

Methodist Le Bonheur Healthcare seeks a Pharmacy Technician to handle precertification of eligible prescription medications for both inpatient and outpatient services. The role requires reviewing clinical information for medical necessity and ensuring documentation meets insurer guidelines for payment.

Ideal candidates have 3-5 years of pharmacy experience, and hold Tennessee state certification and national certification as a Pharmacy Technician.

Qualifications

• High School Diploma or Equivalent is required.
• 3-5 years of Pharmacy experience (clinical, hospital, outpatient, or specialty).
• Currently certified as Pharmacy Technician in Tennessee and by the Pharmacy Technician Certification Board.

Responsibilities

• Precertification of eligible prescription medications for inpatient and outpatient services.
• Review clinical information to determine medical necessity and efficiency of drug use.
• Assist with patient assistance and grant coordination for outpatient pharmacies.
• Determine CPT, HCPCS and ICD-10 codes for prior authorization.
• Contact insurance companies to gather information and organize workflow.

Skills

Clinical pharmacy

EMR documentation

Communication

Attention to detail

Problem solving

Education

High School Diploma or Equivalent

Tools

EMR systems

Microsoft Word

Job description

Methodist Le Bonheur Healthcare seeks a Pharmacy Technician to handle precertification of eligible prescription medications for both inpatient and outpatient services. The role requires reviewing clinical information for medical necessity and ensuring documentation meets insurer guidelines for payment.

Ideal candidates have 3-5 years of pharmacy experience, and hold Tennessee state certification and national certification as a Pharmacy Technician.