Senior Pharm PA/Appeals Technician - Remote in Maine, Vermont, Wyoming, & Iowa
About the position
Responsibilities
• Answer prior authorization inbound calls from providers/members (up to 50 to 70 calls per day) and research and resolve formulary and benefit issues.
• Process authorizations through various computer systems and ensure the accuracy of all data, updating as necessary.
• Receive and process prior authorization requests made by providers and members for medications not inherently covered on a member's prescription drug plan.
• Ensure patient safety and quality of work, maintaining a safe and secure workspace.
• Resolve issues and complaints in a timely manner.
• Perform other duties as assigned by management.
• Gather member data to provide information for pharmacist consultations.
Requirements
• Active National or State Board Pharmacy Technician Licensure.
• Pharmacy Technicians Certification Board (PTCB) certification.
• State Board of Pharmacy Licensure in state of residence.
• ExCPT - Pharmacy Technician Certification with National Healthcareer Association (NHA).
• The National Board of Prior Authorization Specialist certification.
• 6+ months of customer service/customer relations experience with healthcare professionals.
• Basic proficiency with Microsoft Excel, Word, and Outlook.
Nice-to-haves
• Knowledge of call center systems such as IEX.
Benefits
• Paid Time Off which accrues with the first pay period plus 8 Paid Holidays + Floating Holiday.
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account.
• Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage.
• 401(k) Savings Plan, Employee Stock Purchase Plan.
• Education Reimbursement.
• Employee Discounts.
• Employee Assistance Program.
• Employee Referral Bonus Program.
• Flexible Work Arrangement.
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.).
Apply Now
Apply Now
Responsibilities
• Answer prior authorization inbound calls from providers/members (up to 50 to 70 calls per day) and research and resolve formulary and benefit issues.
• Process authorizations through various computer systems and ensure the accuracy of all data, updating as necessary.
• Receive and process prior authorization requests made by providers and members for medications not inherently covered on a member's prescription drug plan.
• Ensure patient safety and quality of work, maintaining a safe and secure workspace.
• Resolve issues and complaints in a timely manner.
• Perform other duties as assigned by management.
• Gather member data to provide information for pharmacist consultations.
Requirements
• Active National or State Board Pharmacy Technician Licensure.
• Pharmacy Technicians Certification Board (PTCB) certification.
• State Board of Pharmacy Licensure in state of residence.
• ExCPT - Pharmacy Technician Certification with National Healthcareer Association (NHA).
• The National Board of Prior Authorization Specialist certification.
• 6+ months of customer service/customer relations experience with healthcare professionals.
• Basic proficiency with Microsoft Excel, Word, and Outlook.
Nice-to-haves
• Knowledge of call center systems such as IEX.
Benefits
• Paid Time Off which accrues with the first pay period plus 8 Paid Holidays + Floating Holiday.
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account.
• Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage.
• 401(k) Savings Plan, Employee Stock Purchase Plan.
• Education Reimbursement.
• Employee Discounts.
• Employee Assistance Program.
• Employee Referral Bonus Program.
• Flexible Work Arrangement.
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.).
Apply Now
Apply Now