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 GED
Minimum 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 skills
Ability 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 skills
Ability 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.

FLORIDA DOCTORS GROUP CORP

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Administrative Pharmacy Technician