Pharmacy Technician – Prior Authorization

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Manage prior authorization requests that are received via phone, fax, or electronic means.

• Utilize computer resources, established criteria, and medication guidelines to conduct clinical research that supports prior authorization evaluations.

• Process approvals and denials for prior authorizations that are approaching their expiration date.

• Ensure documentation is complete, timely, and accurate.

• Evaluate potential denial language for prior authorizations to confirm compliance with NCQA standards.

• Adhere to established workflows, policies, and procedures for prior authorizations.

• Respond to a high volume of inquiry calls regarding prior authorizations from provider offices, pharmacies, and internal stakeholders.

• Convey the status or outcomes of prior authorizations using various computer systems.

• Maintain a balance between productivity, quality, and the timeliness of work.

• Engage in necessary training, continuing education, and team or departmental meetings.

⛳️ Requirements

• A National Pharmacy Technician certification and a current, valid Arizona State Pharmacy Technician license are required and must be maintained.

• 1-5+ years of experience in Pharmacy Prior Authorization processing.

• Capability to handle multiple tasks and prioritize effectively.

• Flexibility to adapt to changing business or departmental needs.

• Strong organizational skills.

• Experience in Retail or Hospital settings is preferred.

• Experience in Managed Care or Medicaid is preferred.

• Familiarity with AS400 systems is preferred.

• Proficiency in utilizing computerized resources and software applications is preferred.

• Proficiency in Microsoft applications, including Excel, Word, and Outlook, is preferred.

• Understanding of pharmacy practices and procedures, with the ability to read and interpret clinical information is preferred.

• Basic knowledge of drug dosage forms, strengths, and the equivalents of generic and brand-name drugs is preferred.

• A High School diploma or G.E.D. is required.

• Access to home internet with a minimum download speed of 100 Mbps.

• A secure workspace or home office is necessary.

• High proficiency in operating a PC and navigating multiple systems and screens.

• Availability to work 40 hours per week, including weekends and holidays.

• Willingness to work extended hours when required.

• A rotating weekend schedule may be necessary.

• Excellent attendance record.

• Strong written and verbal communication skills.

• Proficiency in pronouncing drug names and diagnoses, along with a solid understanding of medical terminology.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources that support physical, emotional, and financial well-being.

• Eligibility for CVS Health bonuses, commissions, or short-term incentive programs.

• Opportunity to work from home.