Pharmacy Technician - Health Plan
Aurora, IL (Western Suburb of Chicago)
Pharmacy Technician Job Summary:
The Prior Authorization (PA) PharmacyTechnician will receive inbound and initiate outbound calls.
Makes outreach calls to members, providers, and patients to resolve medication issues or rejections.
Reviews and resolves all prior authorization emails, questions, and member escalation issues
Completes data entry of prior-authorization requests within the systems
Receives and reviews prescription prior-authorization requests from contracted providers via telephone, fax, email, or surface mail
Provides general PA information requests via telephone, fax, email, or surface mail to providers, members, and/or clients and initiating information requests from providers when additional information is required to adjudicate a prior authorization request
Assist pharmacies, if needed, in resolving obstacles for a PA related medication
Assists participants with manufacturer or other assistance programs
Identifies, reports, and escalates any complaints to immediate manager
Pharmacy Technician Background Profile:
Requires an education level of at least a high school diploma or GED; Associate’s degree is a plus.
Pharmacy technician license required; Certification as a Pharmacy Technician (CPhT) is preferred.
Requires 1-2 years as a pharmacy technician, including telephonic pharmacy prior authorization / pre-certification experience.
Prefer experience working in a managed care setting (Health Plan or Pharmacy Benefit Management/PBM).
Requires working knowledge and experience in prior authorizations and with third party rejects.
Requires basic to intermediary familiarity with Pharmacy/Medical terminology (1-3 years direct experience).
Proficient in Microsoft Office applications, and the ability to learn new and complex computer system applications., such as RxClaims.
Prefer those fully bilingual in English and Spanish.