Prior Authorization Technician

American Oncology NetworkUrbana, IL
2d$19 - $32Remote

About The Position

The technician shall be responsible for the authorization process of orders coming into the Pharmacy from clinics

Requirements

  • High school diploma, GED or equivalent education is required
  • Minimum of two years’ experience in Retail/Specialty/Hospital Pharmacy as a Pharmacy Technician preferred; medical terminology and attention to detail required.
  • 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.
  • 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.
  • Effective communication skills (oral, written, presentation), is an active listener, and effectively provides balanced feedback.
  • 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.
  • 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.
  • Proficiency in MS Office Word, Excel, Power Point, and Outlook required.
  • 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.

Responsibilities

  • 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.
  • 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.
  • Will monitor daily activities and provide backup support where needed, including PAP, SP follow-ups, BV and claims adjudication as needed.
  • Responsible for keeping up on all applicable training and education for maintenance of permit.
  • Will train staff on PA processes.
  • 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.

Benefits

  • 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.
  • As a fast-growing national company, the opportunity to join a national workforce with flexible work options is available.
  • Promoting from within is a priority at AON, and we support our team members continued growth through professional development programs and tuition assistance.

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What This Job Offers

Job Type

Full-time

Career Level

Entry Level

Education Level

High school or GED

Number of Employees

501-1,000 employees

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