Prior Authorization Pharmacy Technician – Rhode Island Pharmacy License
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Job Description
Patient Support Advocate helping patients access specialty medications through prior authorizations, insurance navigation, and financial assistance. Supporting adherence and pharmacy operations for Shields Health Solutions.
Responsibilities:
- Communicate directly with insurance companies to facilitate medication approvals through prior authorizations
- Help patients access financial assistance through foundations, manufacturer programs, and other funding resources
- Navigate pharmacy operating systems to enter data, adjudicate claims, process refills, and create follow-up action plans
- Document patient concerns, prior authorization status updates, and financial assistance needs across databases, electronic medical records, and email systems
- Collaborate with physicians' offices to ensure timely and appropriate medication therapy
- Maintain complete and accurate records of patient communications and case activity
- Assist patients with pharmacy insurance claims and coverage-related issues
- Partner with pharmacists and pharmacy liaisons to deliver coordinated patient care
- Provide phone support and help improve medication adherence and compliance
- Research, investigate, and analyze information for decision-making and problem resolution
- Manage, organize, and maintain data within database applications
- Identify trends, recommend process improvements, and contribute to operational excellence initiatives
- Serve as a trusted business partner to organizational stakeholders
- Protect confidential information and maintain privacy compliance
- Remain current through continuing education, professional publications, and networking
- Travel occasionally as business needs require
- Perform other duties as assigned
Requirements:
- Minimum 1 year of Pharmacy Technician experience
- Strong customer service and patient communication skills
- Experience working with insurance claims, medication access, prior authorizations, or pharmacy operations preferred
- High School Diploma or GED required
- Rhode Island State Registered and/or State Certified Pharmacy Technician, where applicable
- National certification (CPhT or equivalent) strongly preferred but not required
- If the candidate's state of residence does not offer pharmacy technician registration, national certification is required at the time of hire
- Must obtain additional required credentials within a mutually agreed-upon timeframe, if applicable
- Continued employment contingent upon maintaining required licensure and certification requirements
- Solid computer skills
- Proficiency in Microsoft Office tools (Outlook, Teams, Word, Excel, and PowerPoint)
- Ability to navigate the internet and web-based platforms
- Data entry and computer skills will be evaluated through a pre-employment assessment
Benefits:
- Equal employment opportunities
- Inclusive hiring experience
- Application/interview assistance or accommodation available
- Continuing education, professional publications, and networking opportunities
- Occasional travel as business needs require
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