Description -
This position takes in-coming calls from members, providers, etc. providing professional and courteous phone assistance to all callers through the criteria based prior authorization process.
Provides support to the Prior Authorization Department in meeting client expectations regarding efficiency, service levels, privacy maintenance and quality of decision-making.
Responsible for maintaining compliance with ERISA, CMS, and client specific requirements.
Works as part of the team to meet business unit objectives.
Maintains complete, timely and accurate documentation of all approvals and denials, and transfers all clinical questions and judgment calls to the pharmacist.
The Technician will also assist with other duties such as outbound calls, monitoring/responding to inquiries in mailboxes and other duties as assigned by the leadership team.
The Representative will support requirements of the PA team by working as part of a weekend coverage team on a rotating basis where needed.
Experience:
At least 1 year experience as a pharmacy technician coordinating activities in an administrative support function. * State Board of Pharmacy technician certification, registration, or licensure per state regulations. * Advanced computer skills including word processing and spreadsheet utilization. * Excellent customer service skills (written and verbal) a must.
Education
Verifiable High School diploma or GED is required.
No license required
Education: High School