Strategic Staffing Solutions
Title: Pharmacy Technician (Call Center/Help Desk)
Location: Detroit, MI **Remote
Duration: 5month contract with chance of extending or converting to full time.
Role Type: W2 Contract Engagement
Pay Rate: $20/hour
SUMMARY
Department: Pharmacy Help Desk
Support providers (pharmacists and physicians) with Medicare Part D and/or Commercial pharmacy/ specialty drug benefits analysis, drug coverage inquiries and prior authorizations.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Answer telephones in an efficient and timely manner to lend appropriate assistance to providers
- Triage prior authorization requests under the supervision of a Clinical Pharmacist.
- Assists in maintaining pharmacy prior authorization criteria used in the adjudication of pharmacy/specialty claims.
- Analyzing written inquiries which lends to entry and updating of pharmacy authorizations into the claims system.
- Communicate coverage determination status to physicians and/or members and effectuate such decisions within the authorization tool.
- Troubleshoot problems, inquiries, and new processing procedures for coverage determinations.
- Assist with internal control systems and regulations compliance.
EDUCATION AND/OR EXPERIENCE
- High School Graduate of GED equivalent required. Two (2) years of college preferred.
- Two (2) years experience in retail or hospital Pharmacy required.
- Pharmacy Technician Certification (CPhT) preferred.
- Knowledge of prescription drug names, therapeutic classes and claims processing.
- Experience with Medicare Part D prescription benefits may be preferred for some positions.
OTHER SKILLS AND ABILITIES
- Expert knowledge of pharmacy claims processing
- Understanding of formularies and utilization management edits
- Familiarity with pharmaceutical manufacturers and product/cost information
- Computer Literate (Microsoft Office Products).
Job ID: JOB-238180
Publish Date: 02 Oct 2024