Pharmacy Technician – Prior Authorization

Pharmacy Technician – Prior Authorization

Requirements

• National Pharmacy Technician certification and applicable state Pharmacy Technician license, current and in good standing, are required and must be maintained.
• Between 1-5+ years of Pharmacy Prior Authorization processing experience.
• Ability to Multi-task and prioritize work.
• Ability to adjust based on business or department needs.
• Good organization skills.

Responsibilities

• Processes prior authorization requests received by phone, fax, or electronically and utilizes various computer resources, existing criteria, and medication guidelines to perform clinical research to support prior authorization reviews.
• Proactively completes prior authorization approvals and denials that are due to expire and maintains complete, timely, and accurate documentation.
• Reviews potential prior authorization denial language to ensure NCQA requirements are met.
• Follows prior authorization workflow, policies, and procedures during the course of the workday.
• Answers a potentially high volume of prior authorization inquiry calls from provider’s offices, pharmacies, and internal partners and uses various computer resources to communicate prior authorization status or decisions.
• Maintains a balance of productivity, quality and timeliness of work.
• Participates in training and continuing education as required.
• Participates in team/departmental meetings as required.
• Excellent attendance is a must.

Preferred Qualifications

• Retail or Hospital experience
• Managed Care or Medicaid experience
• AS400 experience
• Proficiency in using computerized resources and software applications
• Proficiency with Microsoft applications (Excel, Word, and Outlook)
• Knowledge in pharmacy practices, procedures, and ability to read and understand clinical information
• Working knowledge of drug dosage forms, drug strength, generic and brand name equivalent.