Job Summary
A company is looking for a Clinical Prior Authorization Technician to manage prior authorization requests and ensure compliance with clinical guidelines.
Key Responsibilities
- Prepare and validate prior authorization requests, ensuring compliance with clinical guidelines
- Make outbound calls to providers to gather necessary clinical information for pharmacist review
- Review pharmacy claims data for proactive outreach and escalate provider concerns as needed
Required Qualifications
- 2+ years of pharmacy technician experience in a clinical pharmacy setting
- Experience with prior authorization requests and requirements
- National Certified Pharmacy Technician (CPhT) license is required
- High school diploma or equivalent; Associate's or bachelor's degree preferred
- Ability to work independently in a remote, high-volume environment
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