Prior-Authorization Technician

The GW Medical Faculty Associates (MFA) was incorporated in July 2000 as a not-for-profit, physician-led practice group. The organization functioned as an independent organization in support of The George Washington University School of Medicine and Sciences as a multi-specialty physician practice group. The GW MFA has grown to become the largest independent academic physician practice in the Washington, DC metro region with more than 500 physicians and nearly 200 APP providers. In 2018, the MFA bylaws were revised to allow The George Washington University to serve as the sole corporate member while the MFA retained independent 501c3 status. The purpose of the change was to ensure alignment between the MFA and The George Washington University.

MFA physicians provide comprehensive patient care, offering one practice for the whole person with 52 medical and surgical specialties. As members of the GW School of Medicine and Health Sciences faculty, MFA providers are teachers and mentors for medical students, residents, fellows, and researchers preserving the rich tradition of academics, research, and healing. In addition to maintaining a closely integrated alliance with The George Washington University and The George Washington University Hospital (GWUH) which is separately owned and operated by Universal Health Services (UHS), the GW MFA has active referring relationships with 12 area hospitals.

The GW MFA’s leading healthcare presence in the DC metro region is complemented by a network of community-based practices in DC, Maryland, and Virginia. Given its geographic location in central NW Washington, DC, and proximity to more than 175 resident embassies, the MFA continues to evolve its international clinical outreach.

Position Summary

The Prior Authorization Technician will process prior authorizations and locate foundation assistance for GW Medical Faculty Associates providers.

Essential Duties and Responsibilities

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.

Under the direct supervision of a licensed Pharmacist:

Initiate prior authorizations for medications and work with providers on completion

Confirm patient demographics are accurate and insurance information is correct

Communicate with the clinical team and patients about prior authorization status and provide updates accordingly

Identify patient foundation assistance and manufacturer copay assistance programs

Follow up with the pharmacy to ensure the medication is in process after approval received

Process prior authorization renewals

Work with the provider to resolve prior authorization denials, peer-to-peer reviews, and denials

At all times, maintain a courteous interaction with patients, visitors, departments, and medical personnel

Refer issues that require professional judgment to a pharmacist for follow-up

Other duties assigned Minimum Qualifications

Education

High school diploma or an equivalent combination of education, training, and experience Experience

A minimum of 2 years of Pharmacy Technician experience in retail, specialty, or mail-order pharmacy and a pharmacy license

A minimum of 2 years in an alternative healthcare role (i.e. Certified Nurse Assistant, Medical Assistant, Licensed Practical Nurse) will be considered Physical Requirements

Stand, walk, bend, twist, and reach for long periods of time in a clinical setting.

Must be able to occasionally lift or carry and push or pull up to 100 lbs. as part of the role

Regularly exposed to healthcare settings that may require personal protective equipment

Requires manual dexterity to operate a computer keyboard, calculator, copier machine, and other equipment.