Prior Authorization Pharmacy Technician II

Elevance Health • Mason, OH

6h • Remote

About The Position

The Prior Authorization Pharmacy Technician II interprets and enters moderately complex prescriptions, processes prior authorizations, and troubleshoots adjudication issues. The position is primarily virtual full-time, except for required in-person training sessions. Candidates must live within a reasonable commuting distance of a posting office unless an accommodation is granted. Shifts vary between 8 AM and 8 PM EST.

Requirements

• Hold an active professional license if required by state law, and State Pharmacy Technician Certification or National Certification according to the applicable state or territory requirements, to practice within the scope of practice.
• Have a high school diploma or equivalent and at least 2 years of pharmacy experience, or an equivalent combination of education and experience.
• For URAC-accredited areas, demonstrate strong oral, written, and interpersonal communication, problem-solving, facilitation, and analytical skills.

Responsibilities

• Verify member information and enter data for pharmacists.
• Educate members about pharmacy-based prescription rules, medication resources, and assistance programs.
• Process prior authorization requests from physician offices and ensure compliance with Medicare requirements.
• Inform relevant parties of prior authorization determinations.
• Resolve grievances and appeals issues.
• Respond to inquiries from physicians, the sales team, and members about formularies and prescription benefits.
• Maintain records of prior authorizations, rebates, and monthly reports.

Benefits

• Merit increases
• Paid holidays
• Paid time off
• Incentive bonus programs, unless covered by a collective bargaining agreement
• Medical insurance
• Dental insurance
• Vision insurance
• Short- and long-term disability benefits
• 401(k) with match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED