Pharmacy Technician - Call Center CarelonRx

Remote Full-time
About the position

The Pharmacy Technician I at CarelonRx is responsible for interpreting and entering basic prescriptions, processing prior authorizations, and resolving adjudication issues. This role is essential in ensuring compliance with pharmacy regulations and providing support to members and healthcare providers. The position requires strong communication skills and the ability to educate members on pharmacy-related matters.

Responsibilities
Ā• Verify member information and input data for pharmacists.
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Ā• Educate members on pharmacy rules related to prescriptions and medication resources.
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Ā• Process prior authorization requests from physicians' offices and ensure compliance with Medicare requirements.
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Ā• Inform relevant parties of all prior authorization determinations.
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Ā• Provide resolution to grievances and appeals issues.
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Ā• Respond to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
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Ā• Generate reports relating to rebates, physician utilization, and other ad hoc reports.
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Ā• Maintain record keeping of prior authorizations, rebates, and monthly reports.

Requirements
Ā• High school diploma or GED required.
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Ā• Minimum of 1 year of pharmacy experience or equivalent education and experience.
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Ā• Current State Pharmacy Tech Certification or National Certification based on applicable state(s) required.
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Ā• Strong oral, written, and interpersonal communication skills.
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Ā• Problem-solving skills, facilitation skills, and analytical skills.

Nice-to-haves

Benefits
Ā• 401(k)
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Ā• 401(k) matching
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Ā• Dental insurance
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Ā• Disability insurance
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Ā• Employee stock purchase plan
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Ā• Health insurance
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Ā• Life insurance

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