Job Description

Job Description

Job Description

Job Description

Infusion For Health is dedicated to serving patients with autoimmune disorders and complex chronic conditions through exceptional infusion therapy. Our mission is to provide a patient-focused environment that emphasizes professional care, compassion, and collaboration to ensure optimal treatment outcomes.

The Pharmacy Technician plays a critical role in securing timely insurance approvals for specialty and infusion medications , processing and filling prescriptions, and preparing medications for delivery . This position ensures that all required documentation is obtained and submitted to payers to facilitate patient access to therapy. The ideal candidate will have experience in a specialty or infusion pharmacy and a strong understanding of insurance verification, the prior authorization process, and medication fulfillment workflows for high-cost therapies.

Key Responsibilities:

• Obtain and submit all necessary clinical documentation and forms to insurance companies for prior authorization requests.
• Process and fill prescriptions and pack medications for delivery, ensuring accuracy, compliance, and timely shipment.
• Review new infusion referrals and coordinate benefits investigations for commercial and government payers.
• Proactively follow up with payers, providers, and internal teams to resolve any delays in the authorization process.
• Communicate approval or denial outcomes to patients, prescribers, and pharmacy staff.
• Collaborate with clinical and billing teams to address issues related to denied or delayed authorizations.
• Document all communications and authorization statuses in pharmacy software or CRM systems.
• Maintain a working knowledge of payer-specific policies for infusion therapies, including Medicare, Medicaid, and commercial plans.
• Monitor and track prior authorization expirations and initiate reauthorization processes as needed
• Process, fill, and package prescriptions for delivery while ensuring accuracy and compliance with all regulations.
• Provide exceptional customer service while managing a high volume of calls and tasks.
• Stay up to date on regulatory and payer changes impacting the prior authorization process.

QUALIFICATIONS

• At least 2 years of experience in infusion or pharmacy prior authorization required.
• At least 2 years of experience applying knowledge of Medicare, Medicaid, and Managed Care reimbursement guidelines.
• Experience with prescription processing, fulfillment, and packaging for delivery preferred.
• Ability to effectively manage multiple priorities in a dynamic, paperless environment.
• Proficiency with computer systems, including spreadsheets, word processing, internet research, and email communication.
• Active Pharmacy Technician License required.
• Current knowledge of all applicable state and federal pharmacy laws, rules, and regulations.

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