Prior Authorization Coord-Pharm Tech

General Summary
The PA Coordinator and Pharmacy Technician work in conjunction with clinical teams, patients, and caregivers to facilitate medication and medication-related equipment insurance prior authorizations. They provide accurate and timely non-clinical administrative support, and coordinates all phases of the PA process with the insurance companies, engaging clinical pharmacist and prescriber support as needed.

Key Responsibilities

• Communicates with insurance companies to obtain medication and equipment prior authorizations, and assists with denials and appeals when needed.
• Coordinates and tracks prior authorization renewals, ensuring timely follow-up and completion.
• Manages prescription requests, including prior authorizations, copay verification, specialty pharmacy setup, and referrals for financial assistance.
• Navigates pharmacy systems to enter data, process test claims, and document all patient and insurance interactions in the medical record.
• Collaborates with pharmacists, pharmacy liaisons, and patients to ensure optimal medication access and continuity of care.
• Researches alternative coverage or medication options and maintains accurate, organized records and databases.

Minimum Requirements:

Education/ Certification

• High School Diploma or equivalent
• Current registration as a Pharmacy Technician by the Massachusetts Board of Pharmacy.
• Current certification by the Pharmacy Technician Certification Board or National Healthcareer Association.
• Completion of a Massachusetts Board of Pharmacy approved training program or a minimum of 500 hours worked as a pharmacy technician trainee.

Experience

• 3 years of relevant work experience in a hospital or ambulatory setting, including hospital/physician office work, prior authorization, financial counseling and billing experience preferred.
• Minimum of 1 year in prior authorization management in a healthcare setting preferred
• Other relevant experiences include but are not limited to healthcare/business administration, health insurance, medical policy review and/or pharmacy.

Boston Children's Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork