American Oncology Network LLC
Prior Authorization Technician
American Oncology Network LLC, Fort Myers, Florida, United States, 33916
Location:
Remote Position
Pay Range:
$18.93 - $31.56
Position Summary:
The technician shall be responsible for the authorization process of orders coming into the Pharmacy from clinics
Key Performance Areas:
KPA 1 - Prior and REMS Authorizations 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.
KPA 2 -
Appeals
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.
KPA 3 - Backup to pharmacy staff
Will monitor daily activities and provide backup support where needed, including PAP, SP follow-ups, BV and claims adjudication as needed.
KPA 4 - Education & Training
Responsible for keeping up on all applicable training and education for maintenance of permit.
Will train staff on PA processes.
KPA 5 - Customer Service
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.
Position Qualifications/Requirements:
Education : High school diploma, GED or equivalent education is required
Previous Experience : Minimum of two years' experience in Retail/Specialty/Hospital Pharmacy as a Pharmacy Technician preferred; medical terminology and attention to detail required.
Core Capabilities :
Analysis & Critical Thinking:
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. Interpersonal Effectiveness:
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. Communication Skills:
Effective communication skills (oral, written, presentation), is an active listener, and effectively provides balanced feedback. Customer Service & Organizational Awareness:
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. Self-Management:
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. Computer Skills:
Proficiency in MS Office Word, Excel, Power Point, and Outlook required.
Certifications/Licenses :
Pharmacy technician registration with the Florida Dept of Health in good standing required.
Travel : 0%
Standard Work Days/Hours
: Monday to Friday 9:00 AM - 5:30 PM.
#AONA
Position Summary:
The technician shall be responsible for the authorization process of orders coming into the Pharmacy from clinics
Key Performance Areas:
KPA 1 - Prior and REMS Authorizations 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.
KPA 2 -
Appeals
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.
KPA 3 - Backup to pharmacy staff
Will monitor daily activities and provide backup support where needed, including PAP, SP follow-ups, BV and claims adjudication as needed.
KPA 4 - Education & Training
Responsible for keeping up on all applicable training and education for maintenance of permit.
Will train staff on PA processes.
KPA 5 - Customer Service
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.
Position Qualifications/Requirements:
Education : High school diploma, GED or equivalent education is required
Previous Experience : Minimum of two years' experience in Retail/Specialty/Hospital Pharmacy as a Pharmacy Technician preferred; medical terminology and attention to detail required.
Core Capabilities :
Analysis & Critical Thinking:
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. Interpersonal Effectiveness:
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. Communication Skills:
Effective communication skills (oral, written, presentation), is an active listener, and effectively provides balanced feedback. Customer Service & Organizational Awareness:
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. Self-Management:
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. Computer Skills:
Proficiency in MS Office Word, Excel, Power Point, and Outlook required.
Certifications/Licenses :
Pharmacy technician registration with the Florida Dept of Health in good standing required.
Travel : 0%
Standard Work Days/Hours
: Monday to Friday 9:00 AM - 5:30 PM.
#AONA