Soma Capital Portfolio Jobs

Prior Authorization Pharmacy Technician



Texas, USA · Remote
Posted on Saturday, November 18, 2023

A Prior Authorization (PA) pharmacy technician is responsible for supporting the PA pharmacist team and
assures the PA pharmacists has all of the necessary information and resources needed to perform a clinical review.
The PA technician duties includes receiving incoming PA’s, monitoring the queue’s, faxing final approvals and
denials to prescribers and or members. This is a fast-paced dynamic environment.
This is a remote position, Monday-Friday and may include some Saturday’s.

 Take in-coming calls from members and providers, providing professional phone assistance to all callers
through the criteria based prior authorization process
 Must maintain complete, timely, and accurate documentation of all approvals and denials, and transfers
all clinical questions and judgment calls to the pharmacist
 Determining eligibility and screening incoming pharmacy prior authorization requests for all required
 Preparing, organizing, and distributing pharmacy prior authorization requests for review by
pharmacist/physician and responding to pharmacist/physician requests for additional information
 Collecting relevant medical information (via telephone, fax, and portal) and applying the appropriate PA
 Enters application information, prior authorizations and other relevant data
 Generates reports and other information requested on a scheduled/as needed basis
 Ensure TAT are met for Standard and Expedited requests and are prioritized appropriately
 Ensure drug information is accurate i.e., brand vs. generics
 Meet appropriate metrics per day
 Work with other interdepartmental team such as Medical and pharmacy team

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The
requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable
accommodations may be made to enable individuals with disabilities to perform the essential functions:
● 1+ years of prior PA experience
● 2 years minimum experience as a Pharmacy Technician
● Knowledge of pharmacy law and medical terminology (SIG codes, brand, generic names of
● Outstanding organization skills and keen eye for detail
● Ability to work in a dynamic and fast-paced environment
● Proficient with MS Office applications- Word, Power Point, Excel, and Access
● Strong ability to use and learn new technology tools
● Capable of working independently with minimal supervision and also as part of a team
● Current licensure in applicable state in good standing condition

❑ High School or College education a plus


 For this position the percentage of expected Travel is: 10% of the time