Prior Authorization Pharmacy Technician Specialist - Specialty

Overview:

Prior Authorization Pharmacy Technician Specialist - Specialty Pharmacy

This position is responsible for the timely processing of prior authorizations of infusion and/or clinic administered medications ordered by Providers and administered at any NCH facility. This includes providing appropriate information to third party payers and communicating with clinics when additional information is required to assure prior-authorization is completed appropriately. Incumbent should have strong communication skills, problem solving abilities, detail oriented and customer service skills. This position has independent responsibly for organizing and planning work in order to accomplish daily assignments and tasks.

Schedule: (Full-Time, Benefits Eligible)

Location:

Central Campus700 Children's DrColumbus, Ohio 43205

Why Nationwide Children's Hospital?:

The moment you walk through our doors, you feel it. When you meet our patient families, you believe it. And when you talk with anyone who works here, you want to be part of it. Welcome to Nationwide Children’s Hospital, Where Passion Meets Purpose.

Here, Diversity, Equity and Inclusion are integrated into our core values and practices. We are passionate about building, sustaining and evolving an inclusive and equitable environment. We are seeking individuals who live these values and want to share their experiences and efforts in support of our collective mission.

We’re 14,000 strong. And it takes every one of us to improve the lives of the kids we care for, and the kids around the world we’ll never meet. Kids who live healthier, fuller lives because of the knowledge we share. We know it takes a Collaborative Culture to deliver on our promise to provide the very best, innovative care and to foster new discoveries, made possible by the most groundbreaking research. Anywhere.

Ask anyone with a Nationwide Children’s badge what they do for a living. They’ll tell you it’s More Than a Job. It’s a calling. It’s a chance to use and grow your talent to make an impact that truly matters. Because here, we exist simply to help children everywhere.

Nationwide Children’s Hospital. A Place to Be Proud.

Responsibilities:

Participates in documentation process, obtaining, compiling, maintaining and issuing necessary records, reports, ensuring accuracy of content and correct distribution

Contacts third party payer to obtain prior-authorization for ordered medications and therapy plans. This can be done by portals, faxes or by phone.

Documents prior-authorization information appropriately in the electronic medical record

Provides information requested by Third Party Payers in order to process claim

Reviews Pending Prior-Authorizations and provides follow up if needed

Communicates to clinics when Peer to Peer is requested. These are set up by the ordering clinic

Reviews clinic progress on prior-authorizations that require additional detail for approval

Provides updates to prior-authorization when an order change or schedule change occurs to the exam

Provides additional information requested by Patient Accounts to assist in billing issues involving prior-authorization

Qualifications:

Education: High school diploma or equivalent

Licensure: Board of Pharmacy technician license

Certifications: Completion of a pharmacy technician program, two years of experience as a pharmacy technician (preferably in a setting appropriate for the position, e.g. outpatient, hospital, etc), experienced NCH Outpatient Pharmacy Technician in good standing, or a bachelor’s degree. Certification as a pharmacy technician or documented passing score on certification exam prior to start date

Skills: Demonstrated skills in algebra by passing score on math competency administered on site. Effective interpersonal, verbal and written communication skills. Understanding medical terminology. Ability to problem solve and work independently.

The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individual so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under his/her supervision.

EOE M/F/Disability/Vet

Permanent