Prior Authorization Pharmacy Technician
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Job Location:
Decatur, GA - USA
Monthly Salary:
Not Disclosed
Posted on:
Yesterday
Vacancies:
1 Vacancy
Job Summary
Cardinal Health Innovative Delivery Solutions
With over 45 years of experience in helping hundreds of hospital and outpatient pharmacies we provide access to best practice strategies and tactics to control costs improve workflow and enhance safety. Cardinal Health Innovative Delivery Solutions is one of the largest employers of acute-care pharmacist in the United States.
This position is located at Adams Memorial Hospital
Monday-Friday 9:00am-5:30pm
Schedule: Full-time 40 hours/week
The Pharmacy Technician & Prior Authorization Coordinator is responsible for completing necessary functions to ensure medication coverage as part of an outpatient providers office and to provide consistent excellent patient care. Duties and responsibilities include performing tasks related to the management of third-party billing insurance verification prior authorizations and financial support.
Other responsibilities include supporting multiple facets of the pharmacy such as accuracy and proficiency in data entering coordination of medication refills via telephone filling of medications ordering appropriate packaging and shipments of medications and delivering exceptional customer service.
Responsibilities:
Submit prior authorizations and appeals for brand name high cost drugs in partnership with Outpatient Clinic staff.
Establish and maintain good working relationships with Outpatient Clinic staff to maintain effective communication regarding third-party billing issues.
Review and screen patients to determine if the patient has adequate prescription coverage.
Be a resource in a providers office to answer questions around insurance coverage and copays.
Function as primary third-party billing resource for office and pharmacy staff.
Troubleshoot and resolve billing rejections and subsequently rebill claims to appropriate carrier for all commercial federal and state insurance plans.
Identify patients who may qualify for patient medication assistance programs grants or copay assistance.
Assist with prescription audits.
Assist in the development implementation and evaluation of third-party billing policies and procedures.
Educate office and pharmacy staff about third-party billing policies and procedures as needed.
Gather and document demographics insurance information needs assessment and other data.
Communicate the anticipated self-pay portion (co-payments/deductibles/co-insurance) with patients and establish payment arrangements based on the Financial Policy and document the financial resolution in the registration/billing systems.
Assist in enrollment of patients in manufacturer copay cards.
Participate in ordering medications and pharmacy supplies as needed.
Assist in filling medications as needed.
Participate in educational programs to meet mandatory requirements and identified needs with regard to job and personal growth.
Participate in performance and quality improvement activities as assigned by Director of Outpatient Pharmacy.
Assist in oversight of compliance of the 340B Drug Discount Program.
Ensure appropriate storage of all medications and assist patients with accurate delivery of medication via courier pharmacy pick-up or mail
Qualifications
Previous customer service experience required
Current licensure as a Pharmacy Technician in the state of Indiana
High School diploma or equivalent preferred
Experience conducting and documenting patient health insurance benefit investigations prior authorizations and appeals is preferred
Knowledge of Medicare Medicaid and Commercially insured payer common practices and policies is preferred
Critical and creative thinking is a must
Knowledge of 340B is preferred
Important to have a strong attention to detail and be able to work independently
May require vendor credentialling
Anticipated hourly range:$16.40 per hour - $21.15 per hour
Bonus eligible:No
Benefits:Cardinal Health offers a wide variety of benefits and programs to support health and well-being.
Medical dental and vision coverage
Paid time off plan
Health savings account (HSA)
401k savings plan
Access to wages before pay day with myFlexPay
Flexible spending accounts (FSAs)
Short- and long-term disability coverage
Work-Life resources
Paid parental leave
Healthy lifestyle programs
Application window anticipated to close:04/09/2026 *if interested in opportunity please submit application as soon as possible.
Candidates who are back-to-work people with disabilities without a college degree and Veterans are encouraged to apply.
Cardinal Health supports an inclusive workplace that values diversity of thought experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race religion color national origin ancestry age physical or mental disability sex sexual orientation gender identity/expression pregnancy veteran status marital status creed status with regard to public assistance genetic status or any other status protected by federal state or local law.
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Required Experience:
IC
Key Skills
- Load & Unload
- LTC Pharmacy
- Typing
- Inventory Control
- Customer Service
- Hospital Experience
- Pharmacy Software
- Communication skills
- Math
- Pharmacy Technician Experience
- Order Entry
- Compounding Medications
About Company
Cardinal Health improves the cost-effectiveness of healthcare. We help focus on patient care while reducing costs, enhancing efficiency and improving quality.
