Prior Authorization Technician

Job description

Location: Remote Position 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 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 ca...