About the Company: Well known pharmacy management company in South Orlando has a need for Pharmacy Technicians.
Type: contract – 6 months
Hours: Must have ability to work an 8 hours shift between 8am-9pm and have ability to rotate weekends every 2 months
- Track and triage all coverage determination requests for prior authorizations for State’s Medicaid, Ambetter, and Commercial plans. Provide excellent customer service by taking phone calls from Medical Doctor Offices, Health Plans, and Members while resolving issue.
- Researches, resolves, and documents call inquires in PBM system(s)
- Communicates selected Prior Authorization criteria, pharmacy benefit coverage, and formulary alternatives to physician or physician office staff, or Pharmacist.
- Process prescription exceptions which may include: resolving claim rejects and member and physician outreach.
- Enter member demographics and prescription information into the data processing system.
- Research and resolve rejected insurance billing issues and/or escalated member issues.
- Escalate questions regarding prescription to a Pharmacist for interpretation or provide direction on processing.
- Assist with inbound and/or outbound patient or physician calls.
- Other duties as assigned.
High School diploma
2 years of Pharmacy Technician experience
Current Pharmacy Registration
Ability to use Outlook, Excel, Word
Excellent customer service skills including written and verbal communication
Ability to identify and trouble-shoot problematic issues
Previous Pharmacy Tech experience in PBM (Pharmacy Benefit Management) setting.