Clinical Pharmacy Technician II - Pharmacy Prior Authorizations Job Morgantown area,West Virginia USA,Healthcare

Responsible for securing patient data based upon comprehensive data elements, financial education/counseling, insurance verification, provision of clinical information for pre‑certification, authorization and third‑party claims management. Interviews patients for clinical, financial, and history information and arranges appropriate clinical care. A Clinical Pharmacy Technician will work independently gathering and submitting patient information with oversight of a pharmacist as needed. They will be responsible for performing pharmacy‑related functions in compliance with departmental policies and procedures that provide optimal pharmaceutical care.

Minimum Qualifications

High school diploma or equivalent.
Must possess current licensure as required by state board where services will be provided:
- MD:
  Pharmacy Technician Student Permit or Pharmacy Technician License through Maryland Board of Pharmacy
- OH:
  Pharmacy Technician Trainee License or Certified/Registered Pharmacy Technician License through Ohio Board of Pharmacy
- PA:
  Pharmacy Technician Trainee or Pharmacy Technician License through Pennsylvania Board of Pharmacy
- WV:
  Pharmacy Technician Trainee or Pharmacy Technician License through West Virginia Board of Pharmacy
Nationally Certified Pharmacy Technician through Pharmacy Technician Certification Board (PTCB) or National Health career Association (NHA). OR if applicant has two (2) or more years of pharmacy‑specific experience, must be obtained within 15 months of hire.

Preferred Qualifications

Associate’s degree or post‑high school education in a science field of study, or graduate of a pharmacy technician training program.
Nationally Certified Pharmacy Technician through Pharmacy Technician Certification Board (PTCB) or National Health career Association (NHA) upon hire.

Core Duties and Responsibilities

Drafts various correspondence letters and sends to referral source when necessary.

Gathers and documents patient demographics, insurance information, needs assessment, patient history, and other data as needed.

Initiates refill/follow‑up calls and schedules delivery as needed.

Provides information and answers to patient/caregiver questions and refers to clinician when appropriate or requested.

Identifies all patients requiring pre‑certification or pre‑authorization at the time services are requested or when notified by another hospital or clinic department.

Contacts insurance company or employer to determine eligibility and benefits for requested services.

Maintains patient records in a timely and complete manner.

Assists the pharmacist with the process of filling and labeling the prescriptions.

Calculates initial measurements for compounds and maintains compound logs.

Provides monographs and other required medication guides with each prescription.

Maintains proper storage of medications (e.g., security, temperature controlled items, etc.).

Demonstrates the knowledge and skills necessary to communicate to the infant, pediatric, adolescent, adult and/or geriatric patient per the established age‑specific education/standard.

Works with coordinators and manager to develop and attain quarterly objectives.

Maintains confidentiality according to policy when interacting with patients, physicians, families, co‑workers and the public regarding demographic/clinical/financial information.

Communicates problems hindering workflow to management in a timely manner.

Assists in the training of pharmacy technicians.

Initiates charge anticipation calculations. Accurately identifies anticipated charges to assure identification of anticipated self‑pay portions.

Physical Requirements

Walk and stand or sit for long periods of time.

Lift up to 30 pounds and push up to 50 pounds.

Dexterity required to finger, handle, and reach.

Working Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Skills and Abilities

Must be able to use computers and software applications.

Knowledge of drugs, drug dosing, side effects,…


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