Pharmacy Technician - Prior Authorization - Work From Home (9:30a-6p AZ/MST)

CVS Health•Work At Home-Arizona, AZ

13d•$19 - $35•Remote

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Requirements

National Pharmacy Technician certification and state licensure or applicable state Pharmacy Technician license, current and in good standing, are required and must be maintained
Between 0-5+ years of Pharmacy Technician experience
Ability to multi-task and prioritize work
Ability to adjust based on business or department needs
Good organization skills
Candidate must have their own home internet access with minimum speed of 100mbps download (internet should be hard wired with Ethernet cord).
Candidate must have a secure workspace/office in their home.
Candidate must have high level skill with working with a PC (ex. using mouse and keyboard, accessing and navigating through multiple systems and screens).

Nice To Haves

Retail or Hospital experience
Prior Authorization processing experience
Claims processing experience
Managed Care, Medicare, and/or Medicaid experience
AS400 experience
Proficiency in using computerized resources and software applications
Proficiency with Microsoft applications (Excel, Word, and Outlook)
Knowledge in pharmacy practices, procedures, and ability to read and understand clinical information
Working knowledge of drug dosage forms, drug strength, generic and brand name equivalent.

Responsibilities

Processes prior authorization requests received by phone, fax, or electronically, and utilizes various computer resources, existing criteria, and medication guidelines to perform clinical research to support prior authorization reviews.
Proactively completes prior authorization approvals and denials that are due to expire and maintains complete, timely, and accurate documentation.
Reviews potential prior authorization denial language to ensure NCQA requirements are met.
Follows prior authorization workflow, policies, and procedures during the course of the workday.
Answers a potentially high volume of prior authorization inquiry calls from provider's offices, pharmacies, members, and internal partners, and uses various computer resources to communicate prior authorization status or decisions.
Maintains a balance of productivity, quality, and timeliness of work.
Participates in training and continuing education as required.
Participates in team/departmental meetings as required.
Excellent attendance is a must.
Successful pharmacy technicians will be proficient in drug name and diagnosis pronunciation, recognizing medical terminology, and navigating multiple computer resources to document conversations and prior authorization decisions.
Successful pharmacy technicians will possess good written and verbal communication skills.