Registered Pharmacy Technician

2 weeks ago


San Antonio TX, United States University Health Full time

POSITION SUMMARY/RESPONSIBILITIES
Prepares pharmacy prior authorization requests for review by nurse/pharmacist/physician reviewers. Completes pharmacy authorization requests and issues review outcome notifications to Community First Health Plans (CFHP) members and providers. Follows clinical criteria and instructions to approve prior authorization requests based on established criteria, plan policies and procedures. Performs non-medical research including eligibility verification and benefits verification.

EDUCATION/EXPERIENCE
Graduation from high school/GED required or equivalent experience is required. Some coursework at the college level is preferred. Excellent customer service, phone etiquette, attention to detail, and typing skills is required. Basic knowledge of Microsoft Office and internet is required. Experience in health insurance/pharmacy insurance or managed care organizations preferred. Prior authorization processing experience desired. Experience in a PBM or managed care call center desired. Knowledge of InterQual screening criteria as well as DRG, ICD-10 and CPT coding is preferred. Pharmacy Calculations skills are required.

LICENSURE/CERTIFICATION
Texas State Board of Pharmacy registration required. Certification as a Pharmacy Technician (CPhT) is preferred.



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