Specialty Pharmacy Technician, Prior Authorization
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Job Description
Specialty Operations Pharmacy Technician managing prior authorization requests for specialty medications while ensuring compliance and high-quality patient care. Remote opportunity available in multiple states.
Responsibilities:
- Perform varied activities and moderately complex administrative/technical/operational/customer support assignments
- 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
- Work directly with physician offices to initiate and complete prior authorization requests
- Ensure compliance with quality standards and departmental protocols
- Support the delivery of high-quality patient care and operational excellence
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 meet member/customer needs, absent from all ideal tools
- Experience using multiple applications simultaneously and data entry skills
- 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
Benefits:
- Medical, dental and vision benefits
- 401(k) retirement savings plan
- 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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