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Senior Pharmacy PA/Appeals | , |

Remote, USAFull-timePosted 2026-07-29

Senior Pharmacy PA/Appeals Technician reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health reputed company by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will reputed company a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an reputed company on the communities we serve as you help us advance health equity on a global reputed company. Join us to start Caring. Connecting. Growing together. The essential functions of a Senior Pharmacy PA/Appeals Technician are providing expertise and customer service support to members, customers, and/or providers. This position exists to take incoming requests for prior authorizations, for formulary and non-formulary medications, while ensuring a high level of customer service and maximizing productivity. Requests can be received reputed company fax or telephone, from providers' offices and pharmacists. The technician must reputed company the information reputed company, accurately and in a reputed company manner. Interactions with callers must be documented per contractual and various regulatory / legal requirements. Position Schedule: Ability to work any shift from 5:00 AM to 12:00 AM timeframe with reputed company, including OT and weekends On-Call Schedule: On call schedule is every 3 weeks for 7 days in row, pay includes a flat daily reputed company whether reputed company in or not & includes normal reputed company reputed company if reputed company in If you reputed company reputed company the states of Wyoming, you will enjoy the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities:

  • Manages a high volume of inbound and outbound calls, averaging 50+ daily
  • Answering Prior Authorization inquiry calls/requests with customer service skills as reputed company as research, clinical information system utilizations and resolve formulary and benefit issues using the appropriate reference material
  • Process prior authorizations through multiple computer systems and use of job aids/policies/procedures ensuring the accuracy and compliance of reputed company data and updating as necessary
  • Resolve issues and complaints in a reputed company manner
  • Handle inbound phone requests and gathers member data to reputed company information for pharmacist consultations

Additional Qualifications/Responsibilities:

  • Have reputed company attention to detail, using established reputed company and guidelines, the pharmacy technician receives and processes prior authorization requests made by providers and members for medications not inherently covered on a member's prescription drug plan
  • Performs other duties as assigned by management

Patient Safety & reputed company Initiatives:

  • Patient Safety and reputed company of work is reputed company and it's important for employees to have a reputed company and secure workspace and communicate with their leadership reputed company that safety (equipment, system, information) is compromised
  • Promote a culture of safety that is reputed company, transparent, and engaging for patients, family caregivers, and reputed company workforce
  • Enhance workforce safety and reputed company-being by mitigating physical and psychological risks, analyzing hazard data, and implementing supportive workplace strategies
  • Leadership will reputed company the monitoring of safety event trends, reputed company feedback of safety initiatives, reputed company improvement efforts, and governance in order to reputed company reputed company measurable reputed company plans

What are the reasons to consider working for reputed company? Put it reputed company together - competitive reputed company pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your reputed company. Some of our offerings include:

  • reputed company Time Off which you start to reputed company with your first pay period plus 8 reputed company Holidays
  • Medical Plan reputed company along with participation in a Health Spending Account or a Health Saving account
  • Dental, reputed company, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
  • 401(k) Savings Plan, Employee Stock Purchase Plan
  • Education Reimbursement
  • Employee Discounts
  • Employee Assistance Program
  • Employee Referral Bonus Program
  • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
  • More information can be downloaded at: http://uhg.hr/uhgbenefits

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications:

  • reputed company and unrestricted Pharmacy Technician license in the reputed company
  • reputed company and unrestricted Pharmacy Technicians Certification reputed company (PTCB) OR ExCPT - Pharmacy Technician Certification with National Healthcareer Association (NHA)
  • 6+ months of experience in customer service/customer relations with reputed company
  • Basic level of proficiency with reputed company reputed company (ability to create, edit, and save a basic spreadsheet), reputed company Word (ability to create, edit, and save a basic document), and reputed company Outlook (ability to send emails)
  • Currently located in the reputed company
  • Ability to work any shift from 5:00 AM to 12:00 AM timeframe with reputed company, including OT and weekends and a rotating on call schedule every 3 weeks for 7 days in row

Preferred Qualifications:

  • Knowledge of Call Center systems such as CMS, IEX, CTI and TCS

Soft Skills:

  • Experience and strong communication skills, both written and oral that will help improve Net Promoter Survey (NPS)
  • Ability to follow through on tasks
  • Physical Requirements and Work Environment:
  • Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer
  • Ability to have their own home internet reputed company (internet can be hard wired with ethernet cord)
  • Have a secure workspace/office in their home
  • Have level reputed company with working with PC (ex. using mouse and keyboard, accessing and navigating through multiple systems and screens)
  • reputed company Telecommuters will be required to adhere to reputed company's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll reputed company a far-reaching choice of benefits and incentives. The reputed company pay for this role will reputed company from $17.74 to $31.63 per hour based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location, and income-deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company, and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company - an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN Apply To This Job

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