Role Description
The Pharmacy Technician I β Prior Authorization provides professional and courteous support to members, healthcare providers, pharmacies, and other callers throughout the prior authorization process.
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Handle high-volume inbound calls from members, providers, pharmacies, and other customers.
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Assist callers with the criteria-based prior authorization process while providing excellent customer service.
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Maintain complete, timely, and accurate documentation of prior authorization reviews.
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Review and process prior authorization requests received through fax, electronic portals, and other channels.
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Escalate clinical questions, judgment calls, and appropriate inquiries to the pharmacist team.
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Communicate with internal teams regarding prior authorization status and determinations.
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Monitor and respond to inquiries received through department mailboxes.
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Perform outbound calls and other administrative support duties as needed.
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Follow departmental, company, state, and federal requirements when processing information.
Qualifications
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Verifiable High School Diploma or GED
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Minimum 1 year of customer service experience in a high-volume call center environment with strong written and verbal customer service and communication skills.
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Minimum 1 year of proficiency with Microsoft Outlook and Teams with strong computer, data entry, multitasking, and documentation skills.
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Ability to work the assigned schedule following training, including potential weekend requirements.
Requirements
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Previous experience in healthcare, insurance, pharmacy benefits, pharmacy, medical office, social services, or a similar service environment.
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6+ months of Pharmacy Technician experience, particularly in an administrative support function.
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Pharmacy Technician License, Certification, or Trainee License.
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Prior authorization experience.
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Experience with Microsoft Word and Excel.
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A dedicated, private workspace suitable for handling confidential healthcare information.
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A hardwired internet connection. Wi-Fi-only connections are not acceptable.
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Minimum internet speed of 25 Mbps download and 3 Mbps upload.
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A smartphone for required work applications.
Benefits
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Medical, dental, and vision insurance.
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Flexible spending or health savings account.
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Life and AD&D insurance.
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Short-and long-term disability coverage.
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Paid time off.
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Employee assistance.
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Participation in a 401k program with company match.
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Additional voluntary or legally required benefits.