Virtual Pharmacy Operations Specialist
2 weeks ago
Job Title: Pharmacy Operations Specialist
Position Overview:
As a vital member of the Pharmacy Services team within a distinguished healthcare insurance organization, you will play a crucial role in the management of pharmacy operations. Your primary duties will encompass the evaluation of Prior Authorizations, making preliminary approval or denial determinations, and relaying these decisions to a licensed Pharmacist for conclusive assessment.
Key Responsibilities:
- Review and process Prior Authorizations for various health plans and medications.
- Handle prescription exceptions and address insurance billing discrepancies.
- Communicate directly with members and healthcare providers to resolve inquiries and ensure a smooth service experience.
Essential Skills:
- Certified Pharmacy Technician or Registered Pharmacy Technician.
- Proficient computer skills and experience with insurance billing processes.
- Accurate data entry capabilities into processing systems.
Preferred Attributes:
- Strong communication and interpersonal skills.
- Effective problem-solving abilities and meticulous attention to detail.
- Capacity to manage multiple tasks efficiently.
Job Type: This position is a Contract-to-Hire opportunity.
Work Environment: This role is fully remote, requiring a reliable internet connection and a dedicated workspace. You will be utilizing multiple screens and systems to maintain a high standard of service.
About Actalent:
Actalent is a premier provider of engineering and scientific services and talent solutions. We support innovative companies in advancing their engineering and science projects by connecting them with specialized professionals who enhance scale, innovation, and market speed.
Diversity, Equity & Inclusion:
At Actalent, we are committed to fostering a diverse and inclusive workplace. Our DE&I initiatives are integral to our culture, focusing on:
- Recruiting diverse talent.
- Creating an inclusive environment through ongoing self-reflection.
- Building a culture of care, engagement, and recognition.
- Providing growth opportunities for all employees.
We are an equal opportunity employer and welcome applications from all qualified individuals, regardless of race, gender, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information, or any characteristic protected by law.
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