Prior Authorization Technician – Pharmacy Technician

Shields Health Solutions

Prior Authorization Technician providing patient support through medication access and insurance coordination at Shields Health Solutions. Navigating pharmacy systems and assisting patients directly over the phone.

Posted 5/12/2026full-timeRemote • 🇺🇸 United StatesJuniorWebsite

About the role

Key responsibilities & impact

Provide patient care by removing the barriers to medication access
Work with insurance companies and clinician offices to facilitate approval of medications through prior authorizations
Provide phone support to patients by navigating pharmacy dispensing systems to adjudicate claims, refill medications, and increase adherence in patients
Directly communicate with insurance companies to facilitate the approval of medications
Navigate pharmacy operating systems to input data, perform adjudication on test claims and prepare action plans for follow-up
Effectively communicate across databases, electronic medical records and emails to document patient concerns, prior authorization status, and financial assistance needs
Review prescriptions with doctors' offices to ensure optimal care of the patient
Keep complete and accurate records of patient communications
Assist patients in the management of their pharmacy insurance claims
Work closely with pharmacists and pharmacy liaisons to provide an integrated approach quality patient care
Communicate directly with patients over the phone to assist them in all aspects of medication compliance
Research and investigate information to enable strategic decision-making by others
Manage, organize, and update relevant data using database applications
Apply observations and recommendations to operational issues, increased productivity, quality, and customer-service standards
Identify trends, resolve problems; recommend improvements; implement change
Actively participate in process improvement initiatives
Act as a value-added business partner to stakeholders throughout the organization
Protect organization's value by keeping information confidential
Update job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in professional organizations
Minimal in or out of state travel may be required
Perform other duties as assigned

Requirements

What you’ll need

1+ years as a Pharmacy Technician
State registered or state certified as a pharmacy technician
Nationally certified as a CPhT or equivalent is strongly preferred but not required
High school diploma or GED required

Benefits

Comp & perks

Health insurance
Flexible work hours
Professional development opportunities

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

pharmacy dispensing systemsadjudicationdata inputprior authorizationsmedication complianceclaims managementprocess improvementoperational issue resolutiondatabase applicationspatient care

Soft Skills

communicationproblem-solvingorganizational skillscustomer servicestrategic decision-makingconfidentialitycollaborationresearchadaptabilityparticipation in initiatives

Certifications

CPhTstate registered pharmacy technicianstate certified pharmacy technician