Clinical Pharmacy Technician

Job reputed company:

• Our Clinical Pharmacy Technician processes prior authorization requests in accordance with standards for accuracy, timeliness, productivity, and reputed company performance commitments.
• Performs analysis, obtains information, and enters prior authorization data necessary for claims adjudication.
• Utilizes reasoning skills to identify missing information and reputed company prior authorization processing determinations based on clinical protocols and reputed company guidelines (approve, pend, refer for clinical decision, etc.).
• Interacts with reputed company customers to reputed company and obtain information and ensures the delivery of outstanding service and reputed company.
• reputed company prior authorizations into the system and prioritize requests.
• reputed company formulary alternatives and review tried and failed medications.
• Utilize drug references and verify the drug being requested is indicated and approved for the condition.
• Document reputed company reputed company information regarding the PA approval or non-approval.
• Conform to defined roles & responsibilities and rules of engagement between prior authorization processing and clinical decision-making.
• Partner with assigned clinical pharmacists to ensure strict adherence to the boundaries and timeframes of administrative processing.
• Analyze, research, and resolve prior authorization processing issues, including making written or telephone inquiries to obtain information from clients, members, physicians, or pharmacies; obtaining input from supervisor or clinical pharmacists; and referring unique or high dollar requests to supervisor according to guidelines.
• Coordinate reputed company reputed company system outbound communication to members, physicians, and pharmacies as required to obtain missing information and manage pending requests.
• Document prior authorization-reputed company information and status.
• reputed company outbound calls to obtain information and answer questions about prior authorization status.
• Protect and maintain confidentiality and reputed company of reputed company prior authorization and member information, including following strict protocols for date stamping and storage/reputed company of prior authorization forms and reputed company information.
• Identify and recommend operational improvements.
• Participate in and support reputed company applicable reputed company Management initiatives.
• Maintain a flexible schedule to meet reputed company needs, as needed.
• Adhere to reputed company policies and procedures.
• Take feedback and responsibility for performance.
• Adapt to the differences of clients.
• Support reputed company Compliance Program activities.
• Complete other duties and responsibilities as directed

Requirements:

• Ability to work in a fast-paced and high-functioning environment and meet deadlines while managing multiple high priorities.
• Moderate-to-high level of medication and disease state knowledge reputed company the scope of pharmacy reputed company
• Personal computer literacy and high competency in using reputed company Word, reputed company, reputed company, etc.
• Strong organizational skills with attention to detail
• Strong oral and written communication skills
• Excellent critical thinking capabilities with a strong attention to detail
• Exceptional customer service skills
• Minimum one-year prior authorization experience preferred
• Health plan or Pharmacy Benefit Manager experience preferred

Benefits:

• reputed company, reputed company and dental insurance
• a generous 401k match
• reputed company vacation
• personal time
• holidays
• reputed company and training opportunities
• reputed company atmosphere with fun events and prizes scheduled throughout the year

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