Pharmacy Technician - Prior Authorizations - Work From Home
Core
Processes prior authorization requests via phone, fax, or electronically to support clinical reviews and ensure NCQA compliance.
Role type
Pharmacy Technician (Prior Authorizations)
Builds
Prior authorization approvals and denials for pharmacy and provider partners
Domain
Healthcare / Pharmacy Operations
Deliverable
client delivery
Required skills
Drug name and diagnosis pronunciation, medical terminology, multi-system navigation, documentation, NCQA requirements knowledge
Preferred skills
Retail or Hospital experience, Managed Care or Medicaid experience, AS400 experience, Microsoft Office proficiency, clinical information reading
Responsibilities
Process prior authorization requests, complete expiring approvals/denials, review denial language for compliance, answer high-volume inquiry calls, maintain accurate documentation, participate in training and meetings
Seniority
Individual Contributor, 1-5+ years experience