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Pharmacy Technician
1 month ago
Title: Pharmacy Technician (Call Center/Help Desk)
Location: Detroit, MI (Hybrid/Remote – onsite as needed)
Duration: 16+ Month assignment
Role Type: W2 Contract Engagement
Pay Rate: $20 - 22//hour
SUMMARY
Department: Pharmacy Help Desk
Support providers (pharmacists and physicians) with Medicare Part D and/or Commercial pharmacy/ specialty drug benefits analysis, drug coverage inquiries and prior authorizations.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Answer telephones in an efficient and timely manner to lend appropriate assistance to providers
- Triage prior authorization requests under the supervision of a Clinical Pharmacist.
- Assists in maintaining pharmacy prior authorization criteria used in the adjudication of pharmacy/specialty claims.
- Analyzing written inquiries which lends to entry and updating of pharmacy authorizations into the claims system.
- Communicate coverage determination status to physicians and/or members and effectuate such decisions within the authorization tool.
- Troubleshoot problems, inquiries, and new processing procedures for coverage determinations.
- Assist with internal control systems and regulations compliance.
EDUCATION AND/OR EXPERIENCE
- High School Graduate of GED equivalent required. Two (2) years of college preferred.
- Two (2) years' experience in retail or hospital Pharmacy required.
- Pharmacy Technician Certification (PTCB) preferred.
- Knowledge of prescription drug names, therapeutic classes and claims processing.
- Experience with Medicare Part D prescription benefits may be preferred for some positions.
OTHER SKILLS AND ABILITIES
- Expert knowledge of pharmacy claims processing
- Understanding of formularies and utilization management edits
- Familiarity with pharmaceutical manufacturers and product/cost information
- Computer Literate (Microsoft Office Products).
