- Verifies member information and inputs data for the pharmacists.
- Educates members on pharmacy-based rules related to prescriptions and medication resources or assistance programs.
- Processes prior authorization requests from physicians' offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations.
- Provides resolution to grievances and appeals issues.
- Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
- Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports.
- Maintains record keeping of prior authorizations, rebates, and monthly reports.
- Requires H.S. diploma or equivalent.
- Minimum of 1 year of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
- Current State Pharmacy Tech. Certification or National Certification based on applicable state(s) required.
- For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
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Pharmacy Tech I - Independence, United States - Elevance Health
Description
Pharmacy Technician I
As a Pharmacy Technician I, you will be responsible for the interpretation and data entry of basic prescriptions, prior authorization processing, and troubleshooting adjudication issues.
How you will make an impact:
This position is a hybrid position. You will be required to complete onsite training prior to working from home.
Hours: Monday - Friday (off Saturday and Sunday)
Must be available to work a 8 hour shift within the listed hours in your specified time zones:
9:00am-5:30pm Pacific Time
10:00am-6:30pm Mountain Time
11:00am-7:30pm Central Time
12:00pm-8:30pm Eastern Time
Minimum Requirements:
Preferred skills, contributions, and experience:
