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Pharmacy Technician

4 months ago

Detroit, United States Tekwissen Full time
Overview:

TekWissen Group is a workforce management provider throughout the USA and many other countries in the world. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family, dental and vision, plans for employers, etc.

Title: Pharmacy Technician

Work Location: Detroit MI 48243

Duration: 5 Months

Job Type: Contract

Work Type: Onsite

Dept: Pharmacy Help Desk Comm

Job Description

Engagement Description

  • Support Client providers (pharmacists and physicians) with Commercial pharmacy/ specialty drug benefits analysis, drug coverage inquiries and prior authorization

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
  • 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.
  • Perform other related duties as assigned.
Top 3 Required Skills/Experience -
  • 2 years retail pharmacy experience
  • Knowledge of adjudicating pharmacy claims
  • Computer Literate (Microsoft Office Products)

Required Skills/Experience - The rest of the required skills/experience. Include:
  • Two (2) years experience in retail Pharmacy required.
  • Knowledge of prescription drug names, therapeutic classes and claims processing
  • Expert knowledge of pharmacy claims processing

Preferred Skills/Experience - Optional but preferred skills/experience. Include:

Education/Certifications - Include:
  • High School Graduate of GED equivalent required. Two (2) years of college preferred
  • Pharmacy Technician Certification (PTCB) preferred

TekWissen® Group is an equal opportunity employer supporting workforce diversity.