MaineHealth
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Pharmacy Prior Authorization Technician
role at
MaineHealth
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Job Summary This role is responsible for coordinating and processing prior authorizations (PAs) for prescription medications to ensure timely patient access to treatment. Working closely with providers, pharmacists, payers, and patients, the technician utilizes the EHR and payer portals to facilitate and document the PA process. This hybrid role allows remote work with occasional in‑office training. All experience levels are encouraged to apply.
Key Responsibilities
Review medication orders routed to queue.
Initiate and complete prior authorization requests through electronic portals (e.g., CoverMyMeds, Surescripts, payer websites).
Communicate with insurance companies to gather coverage requirements and status updates.
Collaborate with providers and pharmacists to obtain necessary clinical documentation for PA submissions.
Document PA status, approvals, denials, and follow‑ups.
Notify providers of PA outcomes and assist with alternative medication strategies when necessary.
Track and manage open prior authorizations to ensure timely resolution and refill coordination.
Support clinic staff, pharmacy staff and patients by providing status updates or coverage information as allowed.
Maintain up‑to‑date knowledge of payer formulary changes and authorization requirements.
Participate in continuous quality improvement and workflow optimization efforts.
Perform other pharmacy technician tasks as assigned.
Required Minimum Knowledge, Skills, and Abilities
Education: High school diploma or equivalent required.
License/Certifications: Current or eligible for applicable state(s) license as a Pharmacy Technician.
Experience: None required.
Proficient computer skills.
Benefits
Paid parental leave.
Flexible work policy.
Student loan assistance.
Training and education programs.
Well‑being resources.
Inclusive workplace culture.
With a career at any of the MaineHealth locations across Maine and New Hampshire, you’ll be working with health care professionals that truly value the people around them – both within the organization and the communities that surround it.
If you have questions about this role, please contact
todd.nevins@mainehealth.org
#J-18808-Ljbffr
Pharmacy Prior Authorization Technician
role at
MaineHealth
Get AI-powered advice on this job and more exclusive features.
Job Summary This role is responsible for coordinating and processing prior authorizations (PAs) for prescription medications to ensure timely patient access to treatment. Working closely with providers, pharmacists, payers, and patients, the technician utilizes the EHR and payer portals to facilitate and document the PA process. This hybrid role allows remote work with occasional in‑office training. All experience levels are encouraged to apply.
Key Responsibilities
Review medication orders routed to queue.
Initiate and complete prior authorization requests through electronic portals (e.g., CoverMyMeds, Surescripts, payer websites).
Communicate with insurance companies to gather coverage requirements and status updates.
Collaborate with providers and pharmacists to obtain necessary clinical documentation for PA submissions.
Document PA status, approvals, denials, and follow‑ups.
Notify providers of PA outcomes and assist with alternative medication strategies when necessary.
Track and manage open prior authorizations to ensure timely resolution and refill coordination.
Support clinic staff, pharmacy staff and patients by providing status updates or coverage information as allowed.
Maintain up‑to‑date knowledge of payer formulary changes and authorization requirements.
Participate in continuous quality improvement and workflow optimization efforts.
Perform other pharmacy technician tasks as assigned.
Required Minimum Knowledge, Skills, and Abilities
Education: High school diploma or equivalent required.
License/Certifications: Current or eligible for applicable state(s) license as a Pharmacy Technician.
Experience: None required.
Proficient computer skills.
Benefits
Paid parental leave.
Flexible work policy.
Student loan assistance.
Training and education programs.
Well‑being resources.
Inclusive workplace culture.
With a career at any of the MaineHealth locations across Maine and New Hampshire, you’ll be working with health care professionals that truly value the people around them – both within the organization and the communities that surround it.
If you have questions about this role, please contact
todd.nevins@mainehealth.org
#J-18808-Ljbffr