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Job Details

The Prior Authorization Coordinator will act as onsite triage for identified patients and prescriptions, including specialty prescriptions, to facilitate authorization, reimbursement and dispensing of medications.

Location:

Hybrid, Reading PA

Hours:

8a-4:30p Monday to Friday

Responsibilities:

• Prescription Processing: Master navigation of EMR and dispensing software system.
• Client Support: Provide excellent customer service to patients and healthcare professionals by answering inquiries, addressing pharmacy-related concerns, and triaging to pharmacist as appropriate. Manage multiple clinics with diverse needs autonomously.
• Benefits Investigation: Verify patient information and insurance coverage. Work with pharmacy team members and payers to resolve discrepancies and review insurance for affordability.
• Prior Authorization Assistance: Demonstrate proficiency with prior authorization process by gathering necessary documentation, completing forms, and communicating with healthcare providers and insurance companies to obtain approval for medications. (we have PA team, but still a worthy goal for some of our techs to learn)
• Communication: Display professionalism in all interactions. Communicate effectively in-person, via telephone, and in other electronic communication. Document pertinent patient information professionally and succinctly in patient chart, as agreed upon.
• Team Collaboration: Act as liaison between patient, pharmacy, and other healthcare providers to ensure smooth workflow and effective communication.
• Training: Participate in training of new staff.
• Program Continuity: Oversees continuity of pharmacy processes and adherence to clinical and specialty programs and policies. Participate in quality improvement projects, as deemed relevant and approved by manager.
• Continuous Learning: Stay updated with latest developments in practice area. Participate in training programs and continuing education opportunities to enhance knowledge and skills.
• Perform related duties as assigned

• Ability to communicate professionally and effectively both orally and in writing

• Ability to work independently and as part of a team in a fast-paced environment.

• Exceptional interpersonal and communication skills, with ability to effectively address patient issues and collaborate with healthcare providers.

• Familiarity with pharmaceutical products, pharmaceutical terminology, and clinical pharmacy services

• Strong organizational skills; attention to detail

• Familiarity with prior authorization process and insurance verification.

• Good analytical skills.

• Commitment to maintaining patient confidentiality and privacy.

• Experience in using pharmacy software systems and electronic health records.