Pharmacy Technician Specialist - Prior Authorization - Specialty Pharmacy

at  Nationwide Childrens Hospital

LOCATION:

Central Campus
700 Children’s Dr
Columbus, Ohio 43205
Why Nationwide Children’s Hospital?:
The moment you walk through our doors, you feel it. When you meet our patient families, you believe it. And when you talk with anyone who works here, you want to be part of it. Welcome to Nationwide Children’s Hospital, Where Passion Meets Purpose.
Here, Diversity, Equity and Inclusion are integrated into our core values and practices. We are passionate about building, sustaining and evolving an inclusive and equitable environment. We are seeking individuals who live these values and want to share their experiences and efforts in support of our collective mission.
We’re 16,000 strong. And it takes every one of us to improve the lives of the kids we care for, and the kids around the world we’ll never meet. Kids who live healthier, fuller lives because of the knowledge we share. We know it takes a Collaborative Culture to deliver on our promise to provide the very best, innovative care and to foster new discoveries, made possible by the most groundbreaking research. Anywhere.
Ask anyone with a Nationwide Children’s badge what they do for a living. They’ll tell you it’s More Than a Job. It’s a calling. It’s a chance to use and grow your talent to make an impact that truly matters. Because here, we exist simply to help children everywhere.
Nationwide Children’s Hospital. A Place to Be Proud.

Responsibilities:

• Participates in documentation process, obtaining, compiling, maintaining and issuing necessary records, reports, ensuring accuracy of content and correct distribution
• Contacts third party payer to obtain prior-authorization for ordered medications and therapy plans. This can be done by portals, faxes or by phone.
• Documents prior-authorization information appropriately in the electronic medical record
• Provides information requested by Third Party Payers in order to process claim
• Reviews Pending Prior-Authorizations and provides follow up if needed
• Communicates to clinics when Peer to Peer is requested. These are set up by the ordering clinic
• Reviews clinic progress on prior-authorizations that require additional detail for approval
• Provides updates to prior-authorization when an order change or schedule change occurs to the exam
• Provides additional information requested by Patient Accounts to assist in billing issues involving prior-authorization

Qualifications:

EDUCATION:

• High school diploma or equivalent

SKILLS:

• Demonstrated skills in algebra by passing score on math competency administered on site.
• Effective interpersonal, verbal and written communication skills. Understanding medical terminology. Ability to problem solve and work independently.
  The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individual so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under his/her supervision.

• Participates in documentation process, obtaining, compiling, maintaining and issuing necessary records, reports, ensuring accuracy of content and correct distribution
• Contacts third party payer to obtain prior-authorization for ordered medications and therapy plans. This can be done by portals, faxes or by phone.
• Documents prior-authorization information appropriately in the electronic medical record
• Provides information requested by Third Party Payers in order to process claim
• Reviews Pending Prior-Authorizations and provides follow up if needed
• Communicates to clinics when Peer to Peer is requested. These are set up by the ordering clinic
• Reviews clinic progress on prior-authorizations that require additional detail for approval
• Provides updates to prior-authorization when an order change or schedule change occurs to the exam
• Provides additional information requested by Patient Accounts to assist in billing issues involving prior-authorizatio