Medication Access Pharmacy Technician

Description

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Summary:

The Medication Access Pharmacy Technician is responsible for assisting with medication access to ensure timely patient access to prescribed therpaies, thus improving the health and well-being of those whom we serve. This includes, but is not limited to, managing and completing medication prior authorizations. This role works closely with pharmacists, prescribers, insurance companies and patients to gather required documentation, submit authorizations, track approvals, and resolve denials while maintaining compliance with organizational standards.

Responsibilities:

* Review insurance requirements and payer formularies to determine coverage criteria.

* Complete and submit prior authorization requests for prescription medications.

* Communicate with prescribers to obtain supporting documentation, chart notes, and clinical justifications

* Follow up with insurance plans to track authorization status and resolve delays.

* Communicate approval, denial, or appeal outcomes to pharmacists, providers and patients.

* Initiate and assist with appeal processes or collaborate with pharmacists and providers to identify alternative therapies when prior authorizations are denied.

* Connect patients to medication assistance resources.

* Maintain accurate documentation.

* Ensure compliance with HIPAA.

* Meet productivity, turnaround time, and quality metrics related to medication access.

* Assist in the development and maintenance of standard operating procedures and policies.

* Assist in providing education to prescribers that may enhance the approval rates for prior authorizations and other medication access opportunities.

Other information:

Required

* Certified Pharmacy Technician (CPhT) from the national Pharmacy Technician Certification Board (PTCB)

* High School Diploma or equivalent.

* Three (3) years of experience working in a customer service capacity.

Legal Employer: Pardee - HCHC

Entity: Pardee UNC Health Care

Organization Unit: Blue MD Pharmacy

Work Type: Full Time

Standard Hours Per Week: 40.00

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: DR PARK

Exempt From Overtime: Exempt: No

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.