Pharmacy Technician - Health Plan
Tempe, AZ (Phoenix Metro Area - East Valley)
***Must be a Certified Pharmacy Technician (CPhT) with prior experience at a Health Plan***
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:
Must have valid state or federal license with Pharmacy Technician Certification.
Certification from the Pharmacy Technician Certification Board as a Certified Pharmacy Technician (CPhT) is required.
Around 3-5 years of Pharmacy Technician experience required, preferably in a Hospital or Medical Center environment.
Strongly prefer at least 1 year experience with claims entry and processing for members.
Prefer experience handling prescription claims through Medicare Part D.
Familiarity with Formulary Lists including common edits and restrictions.
Must possess a solid understanding of pharmacy claims from the health insurance perspective.
Demonstrated superior verbal communication skills by telephone.
Possess planning, organizing, conflict resolution, negotiating and interpersonal skills.
Prefer those fully bilingual in English and Spanish.