Pharmacy Technician 2
Core
Interpretation and data entry of moderately complex prescriptions, prior authorization processing, and troubleshooting adjudication issues for a health insurance company.
Role type
Pharmacy Technician II (Claims/Prior Authorization)
Builds
Prior authorization determinations and compliance reports for Medicare and formulary benefits
Domain
Health Insurance / Pharmacy Benefit Management
Deliverable
dashboards & analysis
Required skills
Prescription interpretation, Data entry, Prior authorization processing, Medicare compliance, Grievance resolution, Report generation
Preferred skills
None stated
Technologies
None stated
Responsibilities
Verifies member information and inputs data for pharmacists; Processes prior authorization requests from physician offices; Provides resolution to grievances and appeals issues; Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits; Generates reports relating to rebates, physician utilization, and Beers Criteria; Maintains record keeping of prior authorizations, rebates, and monthly reports.
Seniority
Non-Management Non-Exempt