Pharmacy Care Technician

2 months ago

Minneapolis, United States RTA US Full time
Job DescriptionJob DescriptionWork Mode: Remote
Location: Phoenix AZ / Las Vegas NV / Henderson NV / Reno NV / Tucson AZ / Mesa AZ / Sedona AZ / Santa Fe New Mexico / Albuquerque New Mexico / Salt Lake City UT / Provo UT / Billings MT / Bozeman MT / Missoula MT / Boise ID / Twin Falls ID / Idaho Falls ID / Portland OR / Oregon City OR / Eugene OR / Salem OR / Denver CO / Colorado Spring CO / Boulder CO / Breckenridge CO / Cheyenne Wyoming / Casper Wyoming / Gillette Wyoming

Pay Rate: $18 to $22 an hour (Differs from city to city & experience)

Description:
  • The essential functions of a Pharmacy Technician in Prior Authorization are providing expertise and customer service support to members, customers, and/or providers.
  • This position exists to take incoming requests for prior authorizations, for formulary and non-formulary medications (this can include Commercial, Part D, High Touch Clients, Community and State cliental, Adherence and Monitoring and Prior Authorization Clinical Appeals), while ensuring a high level of customer service and maximizing productivity.
  • Requests can be received via fax or telephone, from providers' offices and pharmacists.
  • The position provides clinical review for authorizations in keeping with legal and contractual requirements, including but not limited to turn around times (TATs) and service level agreements (SLAs).
  • The technician must provide the information clearly, accurately and in a professional manner. Interactions with callers must be documented per contractual and various regulatory / legal requirements.

Primary Responsibilities:
  • Primarily answering prior authorization with inbound calls (up to 50 to 70 calls per day) from providers/members as well as research and resolve formulary and benefit issues using the appropriate reference material
  • Process prior authorizations through various computer systems and use of job aid/policies/procedures ensuring the accuracy of all data and updating as necessary
  • Have sharp attention to detail, Using established criteria and guidelines, the pharmacy technician receives and processes prior authorization requests made by providers and members for medications not inherently covered on a member's prescription drug plan
  • Patient Safety and Quality of work is paramount and it’s important for employees to have a safe and secure workspace and communicate with their leadership when that safety (equipment, system, information) is compromised
  • Resolve issues and complaints in a timely manner
  • Performs other duties as assigned by management
  • Handles inbound phone requests and gathers member data to provide information for pharmacist consultations

Important Note:
  • Training is for 5 weeks.
  • Training time is 8:00am-5:00pm local time. Monday- Friday.
  • This training time is subject to change
  • Shift after training is an 8-hour shift with an hour lunch.
  • Candidate will work 5 days a week which may or may not include a weekend day(s)
  • There may be scheduled overtime and/or working on holidays dependent on business needs
  • Candidate must have their own home internet access (internet can be hard wired with Ethernet cord)
  • Candidate must also have a secure workspace/office in their home
  • Candidate must have level skill with working with PC (ex. using mouse and keyboard, accessing and navigating through multiple systems and screens)
  • Excellent attendance is a must

Required Qualifications:
  • Active National (PTCB) and or State Board of Pharmacy Technician Licensure
  • 6 + months of Customer Service/Customer Relations with Healthcare professionals
  • Basic proficiency with Microsoft Excel (ability to create, edit, and save a basic spreadsheet), Microsoft Word (ability to create, edit, and save a basic document), and Microsoft Outlook (ability to send emails)
  • Able to work 5am to 12 midnight with ability to work flexible hours, including OT and weekends.

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