Prior Authorization Pharmacy Technician

📋 Description

• Utilize Oscar and vendor tools to assess eligibility, screen for necessary documentation, create, process, and accurately track pharmacy prior authorization requests.

• Prepare, organize, and distribute pharmacy prior authorization requests for evaluation by pharmacists/physicians, and address requests for additional information from pharmacists/physicians.

• Gather pertinent medical information (through telephone, fax, and portal) and apply the relevant PA criteria, ensuring all communication and decision-making is clearly documented.

• Adhere to required decision-making timelines, including promptly initiating escalation for cases that necessitate pharmacist review.

• Deliver oral and written notifications of prior authorization outcomes that meet standards and requirements for content and accuracy.

• Ensure compliance with all relevant laws and regulations.

• Perform other duties as assigned.

⛳️ Requirements

• A minimum of 2 years of experience in a pharmacy-related field within a retail or managed care setting and/or prior authorization experience.

• Active and unrestricted Pharmacy Technician certification (CPhT).

• Exceptional customer service skills, phone etiquette, and typing proficiency.

🏝️ Benefits

• Health insurance.

• Participation in a 401(k) plan.

• Accrued paid vacation at a rate of 15 days per year.

• Paid sick time.

• Paid parental leave.

• Life and disability insurance.

• Paid wellness time and reimbursements.