Job Title: Remote Pharmacy Technician (Prior Authorization)
** You must reside in the State of Ohio **
About Us:
Our client is a managed care organization committed to delivering exceptional care and innovative solutions that help individuals lead healthier lives. Our team thrives on collaboration and inclusion, ensuring that we provide the best possible outcomes for the communities we serve. We offer competitive compensation, comprehensive benefits, and career development opportunities in a dynamic and mission-driven environment.
Position Overview:
The Remote Pharmacy Technician (Prior Authorization) is a key member of our team, responsible for handling incoming prior authorization requests for medications. This role supports healthcare providers, members, and pharmacists by ensuring accurate and timely processing of authorizations while delivering exceptional customer service. If you are a detail-oriented professional with pharmacy experience and enjoy working in a remote setting, we encourage you to apply.
Primary Responsibilities:
- Handle incoming prior authorization requests via phone (50-70 calls per day) and fax from healthcare providers and pharmacists.
- Verify member eligibility and accurately process prior authorization requests using established guidelines and systems.
- Research and resolve formulary and benefit-related issues using reference materials and policies.
- Prepare prior authorization requests for clinical review by pharmacists.
- Respond to member and provider inquiries regarding prescription drug plans, coverage, and status updates.
- Document all interactions and actions per regulatory and organizational requirements.
- Collaborate with team members to resolve escalated issues and complaints in a timely manner.
- Maintain patient safety and confidentiality while ensuring quality and compliance with organizational standards.
- Perform additional duties as assigned by management.
- Participate in initial and ongoing training to maintain proficiency and knowledge of policies and systems.
Training and Schedule:
- Training lasts 5 weeks: Monday-Friday, 8:00 AM to 5:00 PM local time (subject to change).
- Post-training: 8-hour shifts with a 1-hour lunch, with availability between 5:00 AM and midnight.
- May include weekend shifts, scheduled overtime, and holiday coverage depending on business needs.
Work Requirements:
- Reliable home internet access with the ability to hardwire via Ethernet.
- A secure and private home workspace free of distractions.
- Proficiency in navigating multiple computer systems and software applications.
- MUST RESIDE IN OHIO
Required Qualifications:
- Active National Pharmacy Technician Certification from one of the following:
- Pharmacy Technician Certification Board (PTCB)
- ExCPT – Pharmacy Technician Certification with National Healthcareer Association (NHA)
- The National Board of Prior Authorization Specialist
- At least 6 months of customer service or healthcare-related experience.
- Basic proficiency with Microsoft Excel, Word, and Outlook.
- Availability to work flexible hours, including overtime, weekends, and holidays.
- Must reside in the state of Ohio.
Preferred Qualifications:
- Familiarity with call center systems such as IEX.
- Strong communication skills, both written and oral.
Soft Skills:
- Exceptional attention to detail and follow-through.
- Ability to handle high call volumes with professionalism and accuracy.
- Effective problem-solving and interpersonal skills.
Physical Requirements:
- Frequent speaking and listening using a headset.
- Prolonged sitting and use of hands for typing and navigating systems.
Benefits:
- Paid Time Off (PTO) and 8 Paid Holidays + Floating Holiday.
- Medical, Dental, Vision, and Life Insurance options, including Short- and Long-Term Disability coverage.
- 401(k) Savings Plan and Employee Referral Bonus Program.
- Education Reimbursement and Employee Assistance Programs.
- Flexible Work Arrangements and Voluntary Benefits