Current jobs related to Pharmacy Prior Authorization Technician - Syracuse - PSG Global Solutions Careers
-
Compounding Pharmacy Technician II
1 hour ago
Syracuse, New York, United States Upstate University Hospital Full timeJob Summary:Under the direct supervision of a licensed pharmacist, this position will prepare and compound sterile and non-sterile medications with a focus on sterile medications, including non-hazardous and hazardous medications. The successful candidate will be responsible for storing and maintaining medication inventory, assisting clinical pharmacists in...
-
Pharmacy Technician
1 month ago
SYRACUSE, United States Wegmans Food Markets Full timeSchedule: Part timeAvailability: Afternoon, Evening (Including Weekends). Shifts end as late as 9pmAge Requirement: Must be 18 years or olderLocation: Syracuse, NYAddress: 3325 West Genesee StreetPay: $19 - $19.50 / hourJob Posting: 08/22/2024Job Posting End: 09/21/2024Job ID:R0220463we are a food market where you make the differenceAt Wegmans, we’re on a...
-
Pharmacy Technician
4 weeks ago
Syracuse, United States Wegmans Food Markets Full timeJob DescriptionSchedule: Part timeAvailability: Afternoon, Evening (Including Weekends). Shifts end as late as 9pmAge Requirement: Must be 18 years or olderLocation: Syracuse, NYAddress: 4722 Onondaga BlvdPay: $19 - $19.50 / hourJob Posting: 08/26/2024Job Posting End: 09/25/2024Job ID:R0220838we are a food market where you make the differenceAt Wegmans,...
-
Pharmacy Technician
4 weeks ago
SYRACUSE, United States Wegmans Food Markets Full timeSchedule: Part timeAvailability: Afternoon, Evening (Including Weekends). Shifts end as late as 9pmAge Requirement: Must be 18 years or olderLocation: Syracuse, NYAddress: 4722 Onondaga BlvdPay: $19 - $19.50 / hourJob Posting: 08/26/2024Job Posting End: 09/25/2024Job ID:R0220838we are a food market where you make the differenceAt Wegmans, we’re on a...
-
Pharmacy Technician
4 weeks ago
Syracuse, United States Wegmans Food Markets Full timeJob DescriptionSchedule: Part timeAvailability: Afternoon, Evening (Including Weekends). Shifts end as late as 9pmAge Requirement: Must be 18 years or olderLocation: Syracuse, NYAddress: 3325 West Genesee StreetPay: $19 - $19.50 / hourJob Posting: 08/22/2024Job Posting End: 09/21/2024Job ID:R0220463we are a food market where you make the differenceAt...
-
Pharmacy Technician
3 days ago
Syracuse, United States Wegmans Food Markets Full timeSchedule: Part timeAvailability: Afternoon, Evening (Including Weekends). Shifts end as late as 9pmAge Requirement: Must be 18 years or olderLocation: Syracuse, NYAddress: 3325 West Genesee StreetPay: $19 - $19.50 / hourJob Posting: 09/13/2024Job Posting End: 10/13/2024Job ID: R0222942we are a food market where you make the difference At Wegmans,...
-
Pharmacy Technician
4 days ago
Syracuse, New York, United States Trinity Health Full timeJob SummaryWe are seeking a highly skilled Pharmacy Technician to join our team at Trinity Health. As a Pharmacy Technician, you will play a critical role in assisting pharmacists in preparing medications for dispensing and maintaining stock in automated dispensing cabinets.Key ResponsibilitiesAssist pharmacists in preparing medications for dispensing,...
-
Authorization Specialist
4 days ago
Syracuse, New York, United States Upstate University Hospital Full timeJob Summary:The Authorization Specialist plays a crucial role in ensuring that all information is accurately coded to obtain authorizations for maximum reimbursements. This involves working closely with providers, patients, ancillary departments, pharmacy, and insurance carriers to ensure seamless communication and efficient processing.Key...
-
Authorization Specialist
4 hours ago
Syracuse, New York, United States SUNY Upstate Medical University Full timeJob Summary:The Authorization Specialist plays a crucial role in ensuring that all information is accurately coded to obtain authorizations for maximum reimbursements. This involves collaborating with providers, patients, ancillary departments, pharmacy, and insurance carriers to guarantee seamless communication and efficient processing.Key...
-
Pharmacy Technician
11 hours ago
Syracuse, New York, United States KPH Healthcare Services, Inc. Full timeAbout the RoleWe are seeking a highly skilled Pharmacy Technician to join our team at KPH Healthcare Services, Inc. As a Pharmacy Technician, you will play a critical role in ensuring the accurate and efficient filling of medication orders.Key ResponsibilitiesCount, seal, and label prescription cards with precision and attention to detail.Pull drugs and...
-
Authorization Specialist
12 hours ago
Syracuse, New York, United States Upstate University Hospital Full timeJob Summary:The Authorization Specialist plays a crucial role in ensuring that all information is accurately coded to obtain authorizations for maximum reimbursements. This involves working closely with providers, patients, ancillary departments, pharmacy, and insurance carriers to ensure seamless communication and efficient processing.Key...
-
Pharmacy Technician Specialist
3 days ago
Syracuse, New York, United States KPH Healthcare Services, Inc. Full timeJob SummaryWe are seeking a highly skilled Pharmacy Technician to join our team at KPH Healthcare Services, Inc. in Syracuse, NY. As a Pharmacy Technician, you will play a critical role in ensuring the accurate and timely filling of medication orders, as well as maintaining a professional and clean appearance in the pharmacy.Key ResponsibilitiesPrepare...
-
Pharmacy Technician Specialist
4 days ago
Syracuse, New York, United States KPH Healthcare Services, Inc. Full timeJob SummaryWe are seeking a highly skilled Pharmacy Technician to join our team at KPH Healthcare Services, Inc. in Syracuse, NY. As a Pharmacy Technician, you will play a critical role in ensuring the accurate and timely preparation of medication orders for patients and providers across the country.Key ResponsibilitiesPrepare medication orders for final...
-
Pharmacy Automation Technician
2 weeks ago
Syracuse, New York, United States Soliant Full timeJob Summary:Soliant is seeking an experienced Pharmacy Technician to join our team in an inpatient setting. As a Pharmacy Technician with Soliant, you will be responsible for preparing and packaging medications, delivering medications to patient care areas, controlling inventory and costs, and working with pharmacy automation and robotics.Key...
-
Pharmacy Technician
6 days ago
Syracuse, New York, United States Walgreens Full timeJob SummaryWe are seeking a highly skilled and detail-oriented Pharmacy Technician to join our team at Walgreens. As a Pharmacy Technician, you will play a critical role in providing exceptional customer service and supporting our pharmacists in the delivery of high-quality patient care.Key ResponsibilitiesAssist pharmacists in the preparation and dispensing...
-
Pharmacy Technician Assistant
4 days ago
Syracuse, New York, United States KPH Healthcare Services, Inc. Full timeJob SummaryWe are seeking a highly skilled Pharmacy Technician to join our team at KPH Healthcare Services, Inc. in Syracuse, NY. As a Pharmacy Technician, you will play a vital role in assisting our pharmacy staff in the triaging of incoming prescriptions, delivering filled prescriptions to patients, and performing cash register duties.Key...
-
Pharmacy Technician Assistant
2 days ago
Syracuse, New York, United States KPH Healthcare Services, Inc. Full timeJob SummaryWe are seeking a highly skilled Pharmacy Technician to join our team at KPH Healthcare Services, Inc. in Syracuse, NY. As a Pharmacy Technician, you will play a vital role in assisting our pharmacy staff in the triaging of incoming prescriptions, delivering filled prescriptions to patients, and performing cash register duties.Key...
-
Certified Pharmacy Technician
2 days ago
Syracuse, New York, United States Walmart Full timeJob SummaryWe are seeking a skilled Pharmacy Technician to join our team at Walmart Supercenter #3848. As a Pharmacy Technician, you will play a vital role in ensuring the smooth operation of our store pharmacy, providing exceptional customer service, and supporting the needs of our customers.Key ResponsibilitiesProcess prescriptions and input data into our...
-
Pharmacy Technician and Delivery Specialist
3 weeks ago
Syracuse, New York, United States Optum Full time$3,000 SIGN ON BONUS FOR EXTERNAL APPLICANTSAbout UsGenoa Healthcare is dedicated to providing exceptional support to the behavioral health and addiction treatment sectors. Our mission transcends mere medication provision; we strive to enhance lives. Individuals facing serious mental or chronic health challenges, along with their caregivers, have profound...
-
Pharmacy Technician Assistant
3 days ago
Syracuse, New York, United States KPH Healthcare Services, Inc. Full timeJob SummaryWe are seeking a highly skilled Pharmacy Technician to join our team at KPH Healthcare Services, Inc. in Syracuse, NY. As a Pharmacy Technician, you will play a vital role in assisting our pharmacy staff in the triaging of incoming prescriptions, delivering filled prescriptions to patients, and performing cash register...
Pharmacy Prior Authorization Technician
4 months ago
Apply now and our proprietary system will quickly have you in front of a live recruiter.
The Opportunity
Description
We're looking for a Pharmacy Prior Authorization Technician, working in Insurance industry in Syracuse.
- Conducts an initial level medication prior-authorization, exception and medical necessity reviews submitted to the plan to determine coverage under the members benefit.
- Routes cases directly to the pharmacist/medical director for final determination, as directed.
- Issues verbal and written member notification as required.
- Reviews and interprets prescription and medical benefit coverage across all lines of business including Medicare D to determine what type of prior authorization review is required, documents any relevant medication history and missing information to assist the pharmacist/nurse/physician in the review process.
- Develops and implements process improvement to increase efficiency in the review process for the clinical staff.
- Works with requesting providers, clinical pharmacists, and other internal staff, as appropriate, in determining whether specific case presentation meets the criteria for approval according to the medical or prescription drug policy and specific coverage criteria.
- Points out nuances that may not be readily apparent regarding the request.
- Contacts pharmacies and physician offices as necessary to obtain clarification on prior authorization requests and drugs being billed through the point-of-sale system and/or medical claim system in order to optimize the member experience.
- Acts as a lead troubleshooter for the pharmacy help desk, customer care and claim processors to coordinate pharmacy and/or medical claims with prior authorization information on file or needed for the member.
- Assures appropriate authorized entry across all lines of business.
- Ensures care management system interfaces to claim processing system for claim payment.
- Performs system testing as required for upgrades and enhancements to the care management system.
- Acts as a content expert for prior authorization intake for our customers, both internal and external.
- Serves as department subject matter expert for pharmacy and medical drug authorizations and coverage.
- Serves as lead liaison for the prior authorization process and its interface to the pharmacy and medical claim systems to troubleshoot.
- Triages issues to the appropriate department for resolution.
- Triages prior authorization workflow daily by rerouting cases, alerting clinical staff of time frame deadlines, monitoring work queues and keeping management aware of issues related to compliance mandated time frames for review completion.
- Provides phone coverage for incoming calls as required to support the UM process. This may include authorization inquiries and information requests, claim inquiries, and other related inquiries. Provides friendly, accurate and timely assistance.
- Supports medical and pharmacy drug pricing questions, and uses drug lookup tools such as government sites, and other online resources.
- Maintains thorough knowledge and understanding of sources of information about health plan contracts, riders, policy statements, and procedures to identify eligibility and coverage and assisting other staff with related inquiries.
- Performs unit specific workflow processes consistent with corporate medical & administrative policies, employer specific guidelines, and/or regulatory agencies.
- Produces, records, or distributes information for others. On a periodic basis, tracks and reports department performance against benchmarks.
- Prepares and assists in handling correspondence. Assures accuracy and timeliness of processing.
- Participates in interdepartmental coordination and communication to ensure delivery of consistent and quality health care services examples include Utilization Management, Quality Management and Case Management.
- Produces, at minimum, the team average medication prior-authorization, exception and medical necessity reviews submitted to the plan to determine coverage under the members benefit.
- Consistently demonstrates high standards of integrity by supporting the company's mission and values, adhering to the Corporate Code of Conduct, and leading to the company's values and beliefs.
- Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
- Performs other functions as assigned by management.
Our Client
Our client is a fast-growing industry-recognized staffing firm. Recruiting critical IT, Financial, Engineering, Healthcare, and Data Analytics talent. With 20+ years' experience and growth.
Connections in Automotive, Healthcare, Retail, Financial & Insurance, and Professional & Business Services. Working to bring top talent together with premier organizations.
Big enough to have great opportunities. Small enough to care about finding the right one for you.
It'sabout relationships based on mutual interest. The results are low turnover, long-lasting partnerships and growth. Want to work for a company invested in your success?
Experience Required for Your Success
- High school diploma
- 2 years experience in health-related field is required (Associates degree preferred)
- Pharmacy Technician certification (CPhT), LPN, Medical Assistant/Technologist background strongly preferred
- Ability to work prolonged periods sitting at a workstation and working on a computer
- Ability to work while sitting and/or standing while at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time
- Typical office environment including fluorescent lighting
- Ability to work in a home office for continuous periods of time for business continuity
- Ability to travel across the Health Plan service region for meetings and/or trainings as needed
- Ability to hear, understand and speak clearly while using a phone, with or without a headset
What Do You Think?
Does your experience reflect what it takes to be successful in this role? Do the work and challenges get you excited about what's possible?
