Pharmacy Technician II
Core
Review and resolve prior authorization requests for pharmacy benefits, acting as a liaison between providers, pharmacies, and the pharmacy department.
Role type
Pharmacy Technician II (Prior Authorization Specialist)
Builds
Pharmacy benefit authorization workflows and provider/pharmacy support
Domain
Healthcare / Pharmacy Benefit Management
Required skills
Data entry, fax communication, telephonic communication, medical terminology, medication names, Microsoft Office (Word, Outlook, Excel), typing 40 WPM, formulary knowledge, Medicaid/Marketplace knowledge
Preferred skills
Pharmacy Technician Certification, 3 years retail/hospital pharmacy experience, 1 year managed care prior authorization experience, ability to acquire state registration in multiple states
Technologies
Windows environment, prior authorization systems, fax systems, ePA
Responsibilities
Review traditional and specialty medication prior authorization requests, contact provider offices to follow up on failed faxes, educate providers about formulary alternatives, initiate routing of authorizations requiring pharmacist review, answer calls regarding prescription coverage and formulary issues, document telephonic interactions, troubleshoot issues from retail and specialty pharmacies, assist Case Managers with pharmacy overrides
Seniority
Mid-level, individual contributor