Job Description

We are seeking a dedicated Certified Pharmacy Technician (CPhT) with managed care experience to join our client’s team as a Prior Authorization Specialist . In this role, you will be responsible for managing prescription prior authorization requests, ensuring accurate data entry and assisting with clinical and customer service support. This is a full-time, remote position starting within 10 days of offer acceptance.

Prior Authorization Specialist Responsibilities:

Receive, review and provide accurate data entry of prescription prior authorization requests
Conduct outreach calls to obtain necessary clinical criteria forms and progress notes
Assist with the onboarding of new employer groups and new membership
Communicate drug formulary guidelines, prior authorization criteria and plan benefit design to participants, providers and pharmacies
Resolve escalated participant issues and claims-related issues
Utilize basic Microsoft Excel functions and track metrics
Support ongoing clinical programs and assist members with obtaining assistance programs
Provide customer service support, including handling member complaints and escalations

Prior Authorization Specialist Requirements:

2+ years of experience as a pharmacy technician
Certified Pharmacy Technician (CPhT) License required
Prior authorization experience within a pharmacy benefit manager (PBM) setting required
Experience with resolving rejected claims and third-party claims adjudication systems
Intermediate Microsoft Excel skills preferred
Patient, provider, and pharmacy customer service experience preferred

Preferred fluency in Spanish
Strong communication, analytical and organizational skills
Detail-oriented with a focus on providing excellent customer service
Ability to interact effectively with patients, providers and coworkers

If you're a qualified Certified Pharmacy Technician with experience in prior authorizations and customer service, and you're excited about this remote opportunity, we encourage you to apply today! We look forward to hearing from you.

Thank you,

Kyla Slayton
Project Manager
LaSalle Network

Job Tags

Remote job, Full time, Contract work, Temporary work,

Similar Jobs

Hirschbach Motor Lines

Orientation Specialist Job at Hirschbach Motor Lines

...The Orientation Specialist works with the orientation team and supports our safety personnel to ensure that vehicles are assigned to drivers, that inspections are prepared on incoming and outgoing trucks, that drivers are appropriately trained and road/skill tested, and...

EVERSANA

Pharmacy Technician Job at EVERSANA

...about EVERSANA, our people, clients and most importantly, the patients we serve. We are EVERSANA. Job Description The Pharmacy Technician is responsible for the preparation and shipment of medications and supplies for individual patients and wholesale facilities...

Porter Steel, Inc.

Field Project Manger Job at Porter Steel, Inc.

...projects. A leader who takes pride in their work, has a strong work ethic and great... ...that materials and workmanship comply with contract documents, approved submittals, and owner... ...Integrity, Partnership, and Fail Forward. Flexible work from home options available.

Lensa

Cybersecurity Analyst Job at Lensa

...Investigate any incidents and implement necessary measures to address them effectively. Install and configure security tools such as CrowdStrike, Tripwire, and Nessus Security Center to ensure the system's security is up to standard. Conduct risk assessments and...

Next Level Marketing

Brand Ambassadors Needed! Must be 21! Job at Next Level Marketing

...industry's leading brandactivation agencies. We operate nationally to build premium brands with our team ofexperienced and passionate beverage professionals specializing in Brand Ambassador Programs. Consumer Sampling Programs, Special Events and Consulting Services....

Prior Authorization Specialist Job at LaSalle Network, Naperville, IL

MFg3VUR4TmRXdVdFd0lRVUlrZ2pCc2JnTVE9PQ==