Pharmacy Technician Prior Authorization Specialist
2 days ago
Job Summary:
We are seeking a highly skilled Pharmacy Technician Prior Authorization Specialist to join our team at Helping Hand Health. As a Pharmacy Technician Prior Authorization Specialist, you will be responsible for processing and finalizing prior authorization requests within regulatory turnaround times.
Key Responsibilities:
- Process and finalize PA requests within regulatory turnaround time (TAT).
- Enter prior authorizations into the system and prioritize requests.
- Check formulary alternatives, review tried and failed medications.
- Utilize drug references and verify the drug being requested is indicated and approved for the condition.
- Accountable to achieve prior authorization processing productivity and accuracy standards.
- Analyzes, researches, and resolves prior authorization processing issues as appropriate for experience and career path level.
- Coordinates notifications to members, physicians, and pharmacies as required to obtain missing information, manage pended requests, and communicate prior authorization determinations.
- Makes outbound calls to obtain information and answer questions about prior authorization status.
- Follow prior authorization processing regulatory requirements and expectations.
- Collaborates with other departments in resolving prior authorization inquiries and handling incoming calls.
- Protects and maintains confidentiality and privacy of all prior authorization and member information.
- Make outreach to members, pharmacies and providers to address quality related gaps in care.
- Field pharmacy related questions from health plan members and health plan staff; appropriately escalate concerns to management in a timely manner.
- Assist with projects such as claim trouble shooting, issue tracking, system configuration, vendor management and other project related tasks.
Requirements:
- 2 years of experience processing prior authorizations for a health plan or Pharmacy Benefit Manager (PBM)
- Bilingual (Spanish)
- Exceptional customer service and professionalism.
- Must have knowledge of pharmacy claims adjudication.
- Must be self-motivated and willing to work effectively and efficiently.
- Active Arizona Pharmacy Technician License or Trainee license
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Glendale, Arizona, United States Helping Hand Health Full timeJob Summary:We are seeking a highly skilled Pharmacy Technician to join our team at Helping Hand Health. As a Pharmacy Technician Prior Authorization Specialist, you will play a critical role in ensuring that our members receive timely and accurate prior authorization decisions.Key Responsibilities:Process and finalize prior authorization requests within...
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Glendale, Arizona, United States Helping Hand Health Full timeJob OverviewAt Helping Hand Health, we are seeking a highly skilled Pharmacy Technician to join our team as a Prior Authorization Specialist. In this role, you will play a critical part in ensuring that our members receive timely and accurate prior authorization decisions.Key ResponsibilitiesProcess and finalize prior authorization requests within regulatory...
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