Clinical Pharmacy Technician II
3 weeks ago
Our company, Prime Therapeutics, is seeking a skilled Clinical Pharmacy Technician II to join our team. As a Clinical Pharmacy Technician II, you will play a crucial role in evaluating and authorizing approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.
Key Responsibilities:
- Evaluate and authorize approval of prior authorization pharmacy requests from prescribers.
- Communicate decision to physicians, physician's office staff, medical management staff, and/or pharmacists.
- Research, resolve, and document prior authorization outcomes in pharmacy system.
- Communicate selected prior authorization criteria, pharmacy benefit coverage, and formulary alternatives to physicians, physician's office staff, medical management staff, and/or pharmacists.
- Escalate requests to Pharmacist when request requires extensive clinical review or denial.
- Monitor telephone system to ensure adequate staffing to maintain client services levels.
- Assess training needs within the team and serve as a training resource, mentor, and coach to others.
Requirements:
- Active pharmacy technician licensure or registration in accordance with state requirements.
- Must have an active national certification (e.g., PTCB or ExCPT) in states that do not require licensure or registration.
- Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
- In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology, and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).
- Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
- Excellent written and verbal communication skills.
- Ability to follow clinical criteria and instructions to approve prior authorization requests.
Education and Certifications:
- GED, High School
- Certifications - Required: CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy - Pharmacy
Work Experience:
- Work Experience - Required: Pharmacy
- Work Experience - Preferred: Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
Compensation:
Potential pay for this position ranges from $17.16 - $25.73 based on experience and skills. Pay range may vary by 8% depending on applicant location.
Benefits:
Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
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