Specialty Pharmacy Technician – Prior Authorization

Role Overview

• Manage daily worklists, conducting follow-ups, and prioritizing authorization requests
• Research and interpret insurance claims, while using a broad array of clinical and informational resources to obtain relevant authorization information
• Work directly with physician offices to initiate and complete prior authorization requests, ensuring compliance with quality standards and departmental protocols
• Operate with opportunities for independent discretion and interpretation within established guidelines

Requirements

• Must have an active license with the Board of Pharmacy in the state of residence (Ohio, Florida, Texas or Arizona)
• Must be certified by the Pharmacy Technician Certification Board (PTCB) or through ExCPT with an active certification
• Must be able to research, read & interpret clinical information
• Critical thinker who can anticipate member/customer needs and take initiative
• Problem solver who can find viable solutions that meets member/customer needs
• Experience using multiple applications simultaneously and data entry skills
• 2+ years of experience as a Pharmacy Technician OR call center experience in a pharmacy or related call center setting.
• Mail Order Pharmacy or Specialty Pharmacy experience
• Experience working with insurance plans and Medicare
• 1+ years of experience submitting and reading pharmacy claims, in RxNova
• Experience with Scriptmed

Benefits

• medical, dental and vision benefits
• 401(k) retirement savings plan
• time off (including paid time off, company and personal holidays, paid parental and caregiver leave)
• short-term and long-term disability
• life insurance