Pharmacy Care Technician

Job Description

Job Description

Work Mode : Remote

Location : Phoenix AZ / Las Vegas NV / Henderson NV / Reno NV / Tucson AZ / Mesa AZ / Sedona AZ / Santa Fe New Mexico / Albuquerque New Mexico / Salt Lake City UT / Provo UT / Billings MT / Bozeman MT / Missoula MT / Boise ID / Twin Falls ID / Idaho Falls ID / Portland OR / Oregon City OR / Eugene OR / Salem OR / Denver CO / Colorado Spring CO / Boulder CO / Breckenridge CO / Cheyenne Wyoming / Casper Wyoming / Gillette Wyoming

Pay Rate : $18 to $22 an hour (Differs from city to city & experience)

Description :

• The essential functions of a Pharmacy Technician in Prior Authorization are providing expertise and customer service support to members, customers, and / or providers.
• This position exists to take incoming requests for prior authorizations, for formulary and non-formulary medications (this can include Commercial, Part D, High Touch Clients, Community and State cliental, Adherence and Monitoring and Prior Authorization Clinical Appeals), while ensuring a high level of customer service and maximizing productivity.
• Requests can be received via fax or telephone, from providers' offices and pharmacists.
• The position provides clinical review for authorizations in keeping with legal and contractual requirements, including but not limited to turn around times (TATs) and service level agreements (SLAs).
• The technician must provide the information clearly, accurately and in a professional manner. Interactions with callers must be documented per contractual and various regulatory / legal requirements.

Primary Responsibilities :

• Primarily answering prior authorization with inbound calls (up to 50 to 70 calls per day) from providers / members as well as research and resolve formulary and benefit issues using the appropriate reference material
• Process prior authorizations through various computer systems and use of job aid / policies / procedures ensuring the accuracy of all data and updating as necessary
• Have sharp attention to detail, Using established criteria and guidelines, the pharmacy technician receives and processes prior authorization requests made by providers and members for medications not inherently covered on a member's prescription drug plan
• Patient Safety and Quality of work is paramount and it’s important for employees to have a safe and secure workspace and communicate with their leadership when that safety (equipment, system, information) is compromised
• Resolve issues and complaints in a timely manner
• Performs other duties as assigned by management
• Handles inbound phone requests and gathers member data to provide information for pharmacist consultations

Important Note :

• Training is for 5 weeks.
• Training time is 8 : 00am-5 : 00pm local time. Monday- Friday.
• This training time is subject to change
• Shift after training is an 8-hour shift with an hour lunch.
• Candidate will work 5 days a week which may or may not include a weekend day(s)
• There may be scheduled overtime and / or working on holidays dependent on business needs
• Candidate must have their own home internet access (internet can be hard wired with Ethernet cord)
• Candidate must also have a secure workspace / office in their home
• Candidate must have level skill with working with PC (ex. using mouse and keyboard, accessing and navigating through multiple systems and screens)
• Excellent attendance is a must

Required Qualifications :

• Active National (PTCB) and or State Board of Pharmacy Technician Licensure
• 6 + months of Customer Service / Customer Relations with Healthcare professionals
• Basic proficiency with Microsoft Excel (ability to create, edit, and save a basic spreadsheet), Microsoft Word (ability to create, edit, and save a basic document), and Microsoft Outlook (ability to send emails)
• Able to work 5am to 12 midnight with ability to work flexible hours, including OT and weekends.
30+ days ago