Certified Pharmacy Tech 1 - Remote
Job Description Summary
Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria in a call center environment.
Job Description
Ā Determines appropriateness for medications. Communicates decision to physicians, physician's office staff, medical management staff and/or pharmacists.
Ā Research, resolves, and documents prior authorization outcomes in pharmacy system.
Ā Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician's office staff, medical management staff and/or pharmacists.
Ā Escalates requests to Pharmacist when request requires extensive clinical review or denial.
Ā Research, resolves, and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.
Ā Performs other duties as required.
Ā For CPTs assigned to work the fax queue, responsibilities will also include:
Ā Clinically reviews coverage determinations with attention to detail, for medications via Fax. Communicates decision to physicians, physician's office staff, medical management staff and/or pharmacists within SLA (service level agreement) guidelines.
Ā Efficiently multi-tasks and monitors several queues and assignments. Adapts to team requirements as business needs change (e.g., fax work, pending queues, oral notifications, and failed faxes).
Company DescriptionBased in Eagan, MN. C4 Technical Services has been a national provider of contingent workforce solutions since 2003.
Women and Minority owned Ā NMSDC Certified
Offices in MN (Corporate), TX, CA
Apply Now
Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria in a call center environment.
Job Description
Ā Determines appropriateness for medications. Communicates decision to physicians, physician's office staff, medical management staff and/or pharmacists.
Ā Research, resolves, and documents prior authorization outcomes in pharmacy system.
Ā Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician's office staff, medical management staff and/or pharmacists.
Ā Escalates requests to Pharmacist when request requires extensive clinical review or denial.
Ā Research, resolves, and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.
Ā Performs other duties as required.
Ā For CPTs assigned to work the fax queue, responsibilities will also include:
Ā Clinically reviews coverage determinations with attention to detail, for medications via Fax. Communicates decision to physicians, physician's office staff, medical management staff and/or pharmacists within SLA (service level agreement) guidelines.
Ā Efficiently multi-tasks and monitors several queues and assignments. Adapts to team requirements as business needs change (e.g., fax work, pending queues, oral notifications, and failed faxes).
Company DescriptionBased in Eagan, MN. C4 Technical Services has been a national provider of contingent workforce solutions since 2003.
Women and Minority owned Ā NMSDC Certified
Offices in MN (Corporate), TX, CA
Apply Now