Job Description
We are currently seeking a Remote Prior Authorizations Pharmacy Technician to join a dynamic healthcare team that provides pharmacy benefits management services. This position offers the opportunity to work from home while contributing to patient care and ensuring timely access to medications.
Key Responsibilities:
As a Remote Prior Authorizations Pharmacy Technician, you will play a vital role in the healthcare process by reviewing and processing prior authorization requests. You will work in a supportive call center environment where you'll receive and review medication requests, either through fax or phone, and ensure they meet the necessary criteria. Your goal is to assist patients in receiving the medications they need by facilitating approval processes.
Key duties include:
Receiving and Processing Requests: Handling incoming requests for prior authorizations for both formulary and non-formulary medications from providers' offices and pharmacists.
Clinical Review: Performing clinical reviews to ensure requests are in line with legal and contractual requirements, including turnaround times (TATs) and service level agreements (SLAs).
Customer Service: Providing expert customer service by communicating clearly, professionally, and accurately with members, providers, and pharmacies, and assisting in resolving any issues that arise.
Documentation: Maintaining detailed, accurate records of all interactions as required by contractual, regulatory, and legal guidelines.
Collaboration: When necessary, reaching out to healthcare providers, pharmacies, or insurance companies to resolve issues related to prior authorization denials.
Training & Schedule:
Training: Comprehensive 4-week training program (Monday-Friday, 8:00 am - 5:00 pm), with no missed time during training.
Work Schedule: Following training, you'll be scheduled for an 8-hour shift with a 1-hour lunch break. Shifts can vary between 5:00 am and midnight, with weekend and holiday availability required based on business needs. Overtime opportunities may also be available, depending on workload.
Preferred Qualifications:
Ability to thrive in a fast-paced, call center environment with strict performance metrics.
Excellent communication, organizational, and interpersonal skills to ensure positive interactions with team members, healthcare providers, and members.
Required Qualifications:
Active Pharmacy Technician License in the state of Florida.
Reliable, high-speed internet connection.
Comfortable working in a remote call center environment with performance goals and metrics.
Compensation:
Hourly Rate: $18.95 - $20.70 per hour, depending on experience.
Benefits:
Health Insurance (Medical, Dental & Vision)
Life Insurance
Employee Assistance Program (EAP)
Access to Investment Accounts
Paid Time Off
Work-from-home flexibility
Employment Type: Full-Time
Salary: $ 18.00 20.00 Per Hour
Job Tags
Hourly pay, Holiday work, Full time, Work from home, Shift work, Night shift, Weekend work, Monday to Friday,