Pharmacy Technician Prior Authorization Specialist Infusion Services
Grand Rapids, MI - USA
Job Summary
Schedule Hours:
- Full-time 40 hours per week
- Days
- Monday-Friday
Position Summary:
The Prior Authorization Technician supports medication access by coordinating prior authorization (PA) requests benefit investigations and MSOT workflows within the Epic electronic health record. This role provides high-quality support to providers office staff and patients across multiple ambulatory clinics. The technician manages complex insurance requirements and serves as the primary point of contact for PA-related needs.
What youll do:
- Prior authorization coordination
- Review payer requirements gather necessary clinical information submit complete PA requests through payer portals fax or phone and coordinate appeal submissions when necessary.
- MSOT workflow management
- Process Multi-Step Order Transmittal tasks ensure accurate internal routing resolve workflow barriers and communicate order status to clinic teams.
- Provider and office staff support
- Respond to PA-related questions from prescribers and clinic staff.
- Request additional documentation when needed.
- Communicate approvals denials and alternative therapy requirements.
- Patient communication
- Provide updates on PA status expected timelines and next steps; assist with understanding insurance requirements.
- Insurance benefit investigation
- Verify coverage copays step therapy rules and formulary alternatives.
- Documentation in Epic
- Maintain accurate timely notes in Epic including PA status payer communication and MSOT task completion.
- Navigate denials identify alternative pathways and escalate only when clinical review is required.
- Ensure PA and MSOT tasks are completed efficiently and routed appropriately to support clinic operations.
- Prioritize and manage multiple concurrent PA and MSOT requests while meeting established turnaround time expectations.
What youll need:
- High school education or equivalent.
- Licensed as a Pharmacy Technician or Pharmacist Intern in the State of Michigan.
- 1 year Pharmacy Tech Work experience.
- Understanding of commercial Medicare and Medicaid insurance plans.
- Familiarity with medical terminology diagnosis codes and PA criteria.
- Preferred: Proficiency with Epic and payer portals.
- Preferred: Experience with prior authorizations insurance billing or ambulatory pharmacy workflows.
- Preferred: Completion of a formal Pharmacy Technician training program; or two years of college with emphasis in math science or medical field applications.
- Preferred: Active status as a Certified Pharmacy Technician (CPhT) by the Pharmacy Technician Certification Board (PTCB)
Our Commitment
Rooted in our Mission and Core Values we honor the dignity of every person and recognize the unique perspectives experiences and talents each colleague brings. By finding common ground and embracing our differences we grow stronger together and deliver more compassionate person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability veteran status or any other status protected by federal state or local law.
Required Experience:
IC
About Company
Trinity Health is one of the largest not-for-profit, Catholic health care systems in the nation. It is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians caring for diverse communities across 25 states. Nationally recognized for care and experience, the Trinity ... View more