Specialty Pharmacy Technician Prior Authorization
About The Position
The Specialty Operations Pharmacy Technician 2 performs varied activities and moderately complex administrative/technical/operational/customer support assignments. Typically work on semi-routine assignments and daily follow ups. Work with providers offices and insurance to troubleshoot and complete medication prior authorization requests for specialty medications. The Specialty Operations Pharmacy Technician 2 (Prior Authorizations) will oversee the following: 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, supporting the delivery of high-quality patient care and operational excellence. Use your skills to make an impact.
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, ask the right questions and deliver the highest quality customer experience.
- Problem solver who can find viable solutions that meets member/customer needs, absent from all ideal tools.
- Experience using multiple applications simultaneously and data entry skills.
Nice To Haves
- 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.
Responsibilities
- 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, supporting the delivery of high-quality patient care and operational excellence.
Benefits
- medical, dental and vision benefits
- 401(k) retirement savings plan
- time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- short-term and long-term disability
- life insurance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
