About The Position

This position provides processing and communication of Specialty and Non-Specialty medication prior authorization referrals reviewed by the Case Review Unit. This position collaborates with Customer Service, Benefits Verification and Pharmacy Operations to communicate referral status and determinations. This position is also responsible for fax processing and providing telephone call assistance for prescriber office staff, pharmacies and members based on program criteria. Maintaining complete, accurate and timely documentation of all appropriate information is necessary. This position also works closely with the Case Review Unit Clinician team for clinical support on daily functions. Other duties may also be assigned by the leadership team.

Requirements

  • Must be Hawaii resident
  • 1 year experience in customer service or call center environment
  • Must be able to work from home, this is a 100% work from home position
  • Have wired high speed internet

Nice To Haves

  • Previous experience in pharmacy or healthcare industry.
  • Associate's or Bachelor's Degree.
  • Certified Pharmacy Technician License

Responsibilities

  • Processing and communication of Specialty and Non-Specialty medication prior authorization referrals reviewed by the Case Review Unit.
  • Collaborating with Customer Service, Benefits Verification and Pharmacy Operations to communicate referral status and determinations.
  • Fax processing.
  • Providing telephone call assistance for prescriber office staff, pharmacies and members based on program criteria.
  • Maintaining complete, accurate and timely documentation of all appropriate information.
  • Working closely with the Case Review Unit Clinician team for clinical support on daily functions.
  • Performing other duties as assigned by the leadership team.

Benefits

  • medical
  • dental
  • vision coverage
  • paid time off
  • retirement savings options
  • wellness programs
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