Job Description

Join Our Cloud Rx Team: Pharmacy Technician – Prior Authorization Specialist

**This role is 100% onsite in the Dallas Fort-Worth, Tx area

About the Role

At Cloud Rx, the Pharmacy Technician plays a vital role in the healthcare system by facilitating the prior authorization process for prescription medications. This individual is responsible for ensuring that patients receive timely approvals for medications that require pre-approval from insurance providers or other relevant entities. The role also involves patient interaction, acting as a liaison and educator to provide guidance and support regarding the prior authorization process and medication adherence. Additionally, the Prior Authorization Specialist is accountable for managing clinic chats to address any queries or concerns related to prior authorizations. At Cloud Rx, we understand that our business thrives when our employees thrive, and it begins with hiring the right Pharmacy Technician.

What You'll Do

The essential functions include, but are not limited to the following:

• Prior Authorization Process Management: Review prescription orders to identify medications requiring prior authorization. Initiate prior authorization by collecting and verifying patient information and medical history. Collaborate with healthcare providers and insurance companies to submit accurate requests. Ensure completed forms and documentation are attached.
• Patient Liaison/Educator: Assist patients with the prior authorization process. Educate patients on its importance and potential outcomes. Address patient concerns and provide medication options. Coordinate with healthcare providers as needed.
• Clinic Chats Management: Conduct real-time chats to resolve prior authorization queries. Collaborate with the healthcare team for seamless communication. Maintain records and follow up on action items.
• Documentation and Compliance: Keep detailed records of prior authorization activities. Comply with pharmacy industry regulations and data protection protocols.
• Quality Assurance and Process Improvement: Participate in quality assurance initiatives. Provide feedback to optimize the prior authorization workflow. Stay updated on insurance policies and industry developments.
• KPIs Responsibilities; Patient turnaround time, other metrics.
• Other assigned duties.

Who You Are

• Certification as a Texas Certified Pharmacy Technician (CPhT) by an accredited certifying body (required).
• In-depth knowledge of pharmaceuticals, medical terminology, and the prior authorization process.
• Strong communication and interpersonal skills to effectively liaise with patients, healthcare providers, and insurance companies.
• Excellent organizational abilities to manage prior authorization requests and clinic chats efficiently.
• Proficiency in using relevant software and systems for prior authorization submissions and documentation.
• Attention to detail and accuracy in completing prior authorization forms and related paperwork.
• Ability to work independently and collaboratively in a fast-paced healthcare environment. 

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