Pharmacy Technician II
Core
Interpret and data entry moderately complex prescriptions, process prior authorizations, troubleshoot adjudication issues, and generate utilization reports for pharmacy members.
Role type
Licensed pharmacy technician (data entry and prior authorization)
Builds
Pharmacy claims processing and member support workflows
Domain
Healthcare / Pharmacy Benefit Management
Deliverable
dashboards & analysis
Required skills
Prescription interpretation, data entry, prior authorization processing, Medicare compliance, grievance resolution, report generation
Preferred skills
Call center experience, PTCB Certification
Technologies
Pharmacy management systems, Medicare adjudication platforms
Responsibilities
Verify member information and input data for pharmacists; Process prior authorization requests from physician offices; Provide resolution to grievances and appeals; Respond to inquiries from physicians and members regarding formulary and benefits; Generate reports on rebates and physician utilization.