Job Description
Position Summary:
The Administrative Pharmacy Technician is responsible for providing administrative and operational support to the pharmacy department by coordinating medication-related workflows, maintaining accurate documentation, assisting with prior authorizations, communicating with providers and health plans, and ensuring compliance with federal, state, HIPAA, and organizational policies. This position does not perform direct dispensing functions but serves as a liaison between providers, pharmacies, insurance carriers, and internal departments to support efficient patient care and pharmacy operations.
Essential Duties and Responsibilities
Pharmacy Administration:
Provide administrative support to the pharmacy department and pharmacy leadership.
Maintain accurate pharmacy records and documentation.
Process and organize incoming pharmacy-related requests.
Monitor pharmacy work queues and ensure timely follow-up.
Maintain provider and pharmacy contact information.
Prepare pharmacy reports and operational summaries.
Assist with departmental projects and workflow improvements.
Prior Authorizations:
Initiate, process, and track medication prior authorizations.
Obtain clinical documentation required by insurance carriers.
Coordinate with providers regarding medication approvals and denials.
Monitor authorization status until resolution.
Maintain documentation of authorization outcomes.
Medication Management Support:
Review medication requests for completeness.
Coordinate prescription refill requests between providers and pharmacies.
Assist with medication formulary reviews.
Research alternative covered medications when appropriate.
Support medication adherence initiatives.
Provider & Pharmacy Relations:
Communicate with retail and specialty pharmacies regarding prescription status.
Coordinate with physician offices regarding medication requests.
Assist providers with pharmacy benefit questions.
Maintain positive relationships with pharmacies and healthcare partners.
Insurance & Payer Coordination:
Communicate with Medicare, Medicaid, Commercial, and Managed Care plans.
Verify medication coverage and eligibility.
Assist in resolving pharmacy claim issues.
Document payer communications.
Escalate complex issues as appropriate.
Documentation & Compliance:
Maintain complete and accurate documentation.
Ensure HIPAA compliance in all communications.
Follow CMS, Medicare, Medicaid, and payer requirements.
Maintain confidentiality of patient information.
Participate in compliance and quality initiatives.
Reporting:- Generate pharmacy operational reports.
- Track authorization turnaround times.
- Monitor medication approval trends.
- Maintain productivity logs and dashboards.
- Report workflow concerns to leadership.
- Cross-Department Collaboration
- Work closely with:
Physicians
Medical Assistants
Referral Coordinators
Billing Department
Case Management
Care Coordination
Provider Relations
Health Plans
Specialty Pharmacies
Required Qualifications:- Active Florida Registered Pharmacy Technician License (preferred or required based on employer needs)
- High School Diploma or GEDMinimum 2 years of pharmacy or healthcare administrative experience
- Strong knowledge of pharmacy terminology
- Experience with prior authorizations
- Knowledge of Medicare Part D, Medicaid, and Commercial pharmacy benefits
- Excellent verbal and written communication skills
- Strong organizational and time management skillsAbility to manage multiple priorities in a fast-paced environment
- Proficiency with Microsoft Office Suite and pharmacy management systems
Preferred Qualifications:- Certified Pharmacy Technician (CPhT)
- Experience in a Managed Care Organization (MCO), IPA, MSO, or medical practice
- Experience with CoverMyMeds or electronic prior authorization platforms
- Experience with electronic health records (EHR/EMR)
- Knowledge of HEDIS and quality initiatives
- Bilingual (English/Spanish)
Knowledge, Skills & Abilities:- Knowledge of pharmacy operations and medication management
- Understanding of insurance formularies and medication coverage
- Strong analytical and problem-solving skills
- Excellent customer service and interpersonal skillsAbility to maintain confidentiality and professionalism
- Strong attention to detail and accuracy
- Ability to prioritize tasks and meet deadlines
- Ability to work independently and collaboratively
Physical Requirements:
Prolonged sitting and computer work.
Ability to communicate effectively by telephone and email.
Ability to occasionally lift up to 20 pounds.
Ability to travel occasionally to provider offices or pharmacy locations if required.
Work Environment:- Professional office environment.
- Standard business hours with occasional overtime as needed.
- Frequent interaction with providers, pharmacies, insurance companies, and internal departments.
- Performance Expectations
- The Administrative Pharmacy Technician is expected to:
- Meet established turnaround times for prior authorizations.
- Maintain accurate and timely documentation.
- Demonstrate excellent customer service.
- Ensure compliance with HIPAA and regulatory requirements.
- Effectively coordinate communication between providers, pharmacies, and health plans.
- Contribute to continuous process improvement initiatives.
- Maintain a high level of professionalism, accountability, and confidentiality at all times.
