Strategic Staffing Solutions
Pharmacy Technician
Location: Detroit, MI
Setting: Hybrid
Contract: 6 Months
Pay rate: 20-22/hr
“Beware of scams. S3 never asks for money during its onboarding process.”
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- 1. Answer telephones in an efficient and timely manner to lend appropriate assistance to providers
- 2. Triage prior authorization requests under the supervision of a Clinical Pharmacist.
- 3. Assists in maintaining pharmacy prior authorization criteria used in the adjudication of pharmacy/specialty claims.
- 4. Analyzing written inquiries which lends to entry and updating of pharmacy authorizations into the claims system.
- 5. Communicate coverage determination status to physicians and/or members and effectuate such decisions within the authorization tool.
- 6. Troubleshoot problems, inquiries, and new processing procedures for coverage determinations.
- 7. Assist with internal control systems and regulations compliance.
- 8. Perform other related duties as assigned.
EDUCATION AND/OR EXPERIENCE:
- 1. High School Graduate of GED equivalent required. Two (2) years of college preferred.
- 2. Two (2) years experience in retail or hospital Pharmacy required.
- 3. Pharmacy Technician Certification (PTCB) preferred
- 4. Knowledge of prescription drug names, therapeutic classes and claims processing
- 5. Experience with Medicare Part D prescription benefits may be preferred for some positions.
OTHER SKILLS AND ABILITIES:
- 1. Expert knowledge of pharmacy claims processing
- 2. Understanding of formularies and utilization management edits
- 3. Familiarity with pharmaceutical manufacturers and product/cost information
- 4. Computer Literate (Microsoft Office Products).
Job ID: JOB-237923
Publish Date: 16 Sep 2024