Full Job Description
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 Information
Job Category:
Other
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