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 managed care and Medicaid plans.
Domain
Healthcare / Pharmacy / Insurance
Required skills
Drug name and diagnosis pronunciation, medical terminology, multi-system navigation, documentation, multi-tasking, prioritization, organization
Preferred skills
Retail or Hospital pharmacy experience, Managed Care or Medicaid experience, AS400 experience, Microsoft Office proficiency, clinical information reading, drug dosage forms knowledge
Technologies
AS400, Microsoft Excel, Microsoft Word, Microsoft Outlook
Responsibilities
Process prior authorization requests received by phone, fax, or electronically; complete prior authorization approvals and denials; review potential denial language for NCQA requirements; answer high volume of inquiry calls from providers and pharmacies; maintain accurate documentation; participate in training and team meetings.
Seniority
Individual Contributor, 1-5+ years experience