Pharmacy Prior Authorization Technician - Dermatology.

Description

Professional - Clinical
Req #: 74022

Summary:

The Pharmacy Prior Authorization Technician 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 role is key to supporting the clinical team in minimizing treatment delays and improving medication access.

Key Responsibilities:

• Review medication orders routed to thePrior Authorization Workqueue in Epic.
• Initiate and completeprior 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 within Epic using SmartPhrases and encounters.
• 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 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.

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Additional Information

If you have questions about this role, please contact sarah.donlin@mainehealth.org