A Prior Authorization (PA) Coordinator is responsible for obtaining pre-approval from insurance companies for medications ensuring patients receive necessary care without undue financial burden. Key duties include verifying patient insurance benefits, collecting and submitting clinical and demographic information, communicating with insurance providers to process requests and resolve denials

• Determine patient eligibility and benefits for specific medications by contacting insurance providers.  

• Collect required demographic, clinical, and insurance details from patients, physicians, and clinical staff to support authorization requests.  

• Initiate, submit, and track prior authorization requests through various portals and systems, ensuring timely processing by the insurance company.  

• Act as a liaison between patients, referring physicians, clinical staff, and insurance companies to communicate status updates, resolve discrepancies, and provide requested information.  

• Follow up on denied claims, gather additional documentation, and coordinate with the clinical team to file appeals and secure approvals.

• Maintain clear and accurate logs of all authorization attempts, communications, decisions, and approvals in patient records and organizational databases.

• Adhere to strict HIPAA regulations and company policies to protect patient information and ensure the privacy and security of all data.

• High School Diploma,

• Active State of Oregon Pharmacy Technician License, including the completion and maintenance of job-specific competencies and certifications.

   

Job Related Knowledge, Skills and Abilities (Competencies):

• Must possess computer keyboarding skills.

• Excellent interpersonal communication
• Knowledge base of insurance reimbursement.
• Knowledge of managed care environment.
• Successfully completes initial and continued competencies as required for maintenance of standard of practice, legal regulatory compliance, and OHSU policies.

• Formal pharmacy technician training program
• Oregon Board of Pharmacy Certified Technician license
• Inpatient and outpatient hospital pharmacy experience.
• Medical and scientific nomenclature.

The Pharmacy Technician will experience competing demands on their time from patients and/or clinic staff and will need to effectively multitask. This pharmacy serves a largely indegent patient population so a non-judgemental and compassionate demeanor is prefferable. Must be able to deliver a consistantly high level of customer service. Possible exposure to hazardous chemicals and noise. Flexibility in scheduling of shift times. Working Hours: Monday-Friday 7:00 am to 7:30 pm, Saturdays from 8:30 am to 1:30 pm, all technicians participate in fair shar Saturday rotation.

 

 

Oregon Health & Science University values a diverse and culturally competent workforce. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against applicants on the basis of any protected class status, including disability status and protected veteran status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are encouraged to apply. To request reasonable accommodation contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or aaeo@ohsu.edu.