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Pharmacy Technician Specialist

2 months ago

Detroit, Michigan, United States Strategic Staffing Solutions Full time
Strategic Staffing Solutions is seeking a skilled Pharmacy Technician to join our team. As a Pharmacy Technician, you will play a critical role in supporting our pharmacy operations. Your primary responsibilities will include answering telephones, triaging prior authorization requests, and maintaining pharmacy prior authorization criteria. You will also analyze written inquiries, communicate coverage determination status, and troubleshoot problems. Additionally, you will assist with internal control systems and regulations compliance. To be successful in this role, you will need a high school diploma or equivalent, two years of experience in retail or hospital pharmacy, and a Pharmacy Technician Certification (PTCB) preferred. You will also need to have expert knowledge of pharmacy claims processing, understanding of formularies and utilization management edits, and familiarity with pharmaceutical manufacturers and product/cost information. If you have a strong background in pharmacy operations and are looking for a challenging and rewarding role, we encourage you to apply.

**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
* Maintain pharmacy prior authorization criteria used in the adjudication of pharmacy/specialty claims
* Analyze 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 or 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)

**About Strategic Staffing Solutions:**

Strategic Staffing Solutions is a leading provider of staffing services to the healthcare industry. We are committed to providing our clients with the highest quality candidates and our candidates with the best possible experience.

**Equal Opportunity Employer:**

Strategic Staffing Solutions is an equal opportunity employer and welcomes applications from diverse candidates.