Pharmacy Technician II

Elevance Health•Atlanta, GA

4d•Remote

About The Position

The Pharmacy Technician II interprets and enters moderately complex prescriptions, processes prior authorizations, and troubleshoots adjudication issues. The role verifies member information and enters data for pharmacists, educates members about prescription-related pharmacy rules and medication resources or assistance programs, and processes requests from physicians’ offices while ensuring Medicare requirements are met. The technician communicates prior authorization determinations to relevant parties, helps resolve grievance and appeal issues, and responds to inquiries from physicians, sales teams, and members about formularies and prescription benefits. The role also generates reports on rebates, physician utilization, Beers Criteria, Reliance members, and other requested topics, and maintains records for prior authorizations, rebates, and monthly reports. The position is primarily virtual, with required in-person training sessions. Candidates must reside within a reasonable commuting distance of a posting location unless an accommodation is granted. The schedule is an eight-hour shift from 12:00 p.m. to 8:30 p.m. Eastern Time, Monday through Friday. Additional hours, including weekends or holidays, may be required based on operational needs.

Requirements

Active professional license, if required by state law, and State Pharmacy Technician Certification or National Certification according to applicable state or territory requirements.
High school diploma or equivalent and at least 2 years of pharmacy experience, or an equivalent combination of education and experience.
For the CPCC business area, a current Pharmacy Technician license and certification is required.

Nice To Haves

Call center experience.
PTCB Certification is strongly preferred.
For URAC-accredited areas: strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Responsibilities

Verify member information and enter data for pharmacists.
Educate members about pharmacy rules related to prescriptions and about medication resources or assistance programs.
Process prior authorization requests from physicians’ offices in compliance with Medicare requirements.
Inform relevant parties of prior authorization determinations.
Resolve grievances and appeals issues.
Respond to inquiries from physicians, sales teams, and members about formularies and prescription benefits.
Generate reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc topics.
Maintain records of prior authorizations, rebates, and monthly reports.
Interpret and enter moderately complex prescriptions and troubleshoot adjudication issues.