Prior Authorization Technician Senior Rep

Prior Authorization Technician Senior Rep

Requirements

• High School Diploma, or GED required.
• 2+ years of Pharmacy Technician experience.
• Valid National Pharmacy Technician certification is required.
• Valid Arizona, Massachusetts or Illinois State pharmacy technician license is required.
• Microsoft Office proficiency and data entry skills.
• Strong math skills related to prescription calculations.
• Exceptional attention to detail, accuracy, and quality.
• Excellent verbal and written communication skills.
• Ability to multitask in both PC/Phone related tasks.
• 1+ year relevant experience with prior authorization submission using CoverMyMeds or other like electronic prior authorization tools.
• Experience with prior authorization appeals and denials.
• Experience working with clinical EMR systems and/or Infertility is a plus, but not required.
• Works effectively and fosters teamwork; Demonstrates ownership of projects and carries responsibility for building strong working relationships with colleagues and customers.
• Results oriented; demonstrated ability to prioritize and manage workload and meet deadlines.

Responsibilities

• Accurately enter prescriptions into our system, adjudicate claims and work rejections.
• Use the knowledge you gain from training, your problem-solving skills and support from your team to accurately process prescription claims so they will be dispensed accurately.
• Accurately use the clinic specific EMR to gain additional information needed to submit prior authorizations.
• Adhere to principles as stipulated by program specific contractual agreements and company practices.
• Rapid and thorough investigation of processing/benefit inquiries from Fertility Inside Sales team.
• Insurance Inquiries/benefit checks.
• Prior Authorization submission, follow up and appeals as needed.
• Juggle multiple tasks without sacrificing attention to detail.
• Help patients and providers understand their pharmacy benefits better and answer questions effectively.
• Use your strong communication skills to handle internal and external inquiries regarding prior authorizations.
• Participates in program specific customer meetings and training sessions.
• Participate in special projects and perform other duties as it pertains to specific contract performance.

Preferred Qualifications

• Experience with prior authorization appeals and denials.
• Experience working with clinical EMR systems and/or Infertility is a plus, but not required.