Pharmacy Technician - Prior Authorization Tech

$43,014 - $66,664/Yr

University of Virginia - Charlottesville, VA

Full-time

Charlottesville, VA

Educational Services

About the position

As a Prior Authorization Technician at UVA Specialty Pharmacy, you will play a crucial role in positively impacting the lives of patients by obtaining medication authorizations from insurance plans. This position is vital for enhancing patient access to necessary treatments and supporting overall healthcare outcomes. You will be responsible for assessing patient eligibility, investigating pharmaceutical medication assistance programs, and staying informed about changes in carrier contracts and departmental policies.

Responsibilities

• Prioritize and process incoming prior authorization requests with urgency, utilizing CoverMyMeds, payer websites, and phone calls as needed.
• Review and verify patient information, medical records, and insurance coverage to ensure accurate and complete documentation for authorization submissions.
• Collaborate with healthcare providers, insurance companies, and internal departments to obtain necessary information and documentation for prior authorization requests.
• Initiate appeals for denied authorizations, and follow-up regularly on pending cases.
• Obtain copay assistance for patients.
• Maintain accurate and up-to-date records of all prior authorization requests, approvals, and denials.
• Ensure compliance with regulatory requirements and company policies regarding documentation and record-keeping.
• Communicate with clinic staff and pharmacies keeping everyone informed on authorization status and requirements.
• Contact patients to discuss authorization status and to set up delivery of medication(s).
• Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations.
• Consistently follow policies and procedures required by state and federal laws, and as required by UVA Health System.
• Triage and escalate any questions or issues outside the pharmacy technician scope of practice to the staff pharmacist or supervisor as needed.
• Participate in the training of new employees.

Requirements

• High School Graduate or Equivalent
• 6 months minimum relevant experience required
• Commonwealth of Virginia Pharmacy Technician Registration required
• CPhT credential through National Healthcareer Association (NHA) or Pharmacy Technician Certification Board (PTCB) required.