- Prime Therapeutics (Boston, MA)
- …skills. + Ability to follow clinical criteria and instructions to approve prior authorization requests. + Minimum of 2 years dispensing or retail experience ... Technician - Remote **Job Description** Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone… more
- Beth Israel Lahey Health (Westwood, MA)
- …**Essential Responsibilities:** 1. Understands product and payer reimbursement landscape and prior authorization guidelines and processes. 2. Collects and ... reviews all data needed pharmacy and/or medical for prior authorization approvals. 3. Resolves insurance related...provider and pharmacy staff; and clarifies prescription orders with pharmacist and/or clinician as appropriate. 5. Serves as the… more
- Highmark Health (Boston, MA)
- …claims history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network ... requests for drug authorizations or denials. + Review of prior authorization criteria for drug products. +...and/or additional information when necessary. + Consult with staff clinical pharmacist for guidance and assistance as… more
- Beth Israel Lahey Health (Needham, MA)
- …and pharmacy buyer when inventory levels are low. + Receives requests for Prior Authorization from pharmacy or Tier Exception/PAF request from patient, completes ... information in the medical record. Under the supervision of a pharmacist , and according to departmental policies, procedures and guidelines, the Medication… more