Immediate Hiring: Senior Pharm PA/Appeals Technician - Remote in
Role Snapshot:Start Date: Immediate openings availableLocation: RemoteCompany: Florida, North Carolina, & GeorgiaPosition: Senior Pharm Pa/appeals Technician - RemoteCompensation: a competitive salary  About the position
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The essential functions of a Pharmacy Technician in Prior Authorization are providing expertise and customer service support to members, customers, and/or providers. This position exists to take incoming requests for prior authorizations, for formulary and non-formulary medications, while ensuring a high level of customer service and maximizing productivity. Requests can be received via fax or telephone, from providers' offices and pharmacists. The position provides clinical review for authorizations in keeping with legal and contractual requirements, including but not limited to turn around times (TATs) and service level agreements (SLAs). The technician must provide the information clearly, accurately, and in a professional manner. Interactions with callers must be documented per contractual and various regulatory/legal requirements.
Responsibilities
 Answer prior authorization inbound calls (up to 50 to 70 calls per day) from providers/members and research and resolve formulary and benefit issues using appropriate reference material.
,
 Process authorizations through various computer systems and use job aids/policies/procedures ensuring the accuracy of all data and updating as necessary.
,
 Receive and process prior authorization requests made by providers and members for medications not inherently covered on a member's prescription drug plan using established criteria and guidelines.
,
 Ensure patient safety and quality of work, maintaining a safe and secure workspace and communicating with leadership when safety is compromised.
,
 Resolve issues and complaints in a timely manner.
,
 Perform other duties as assigned by management.
,
 Handle inbound phone requests and gather member data to provide information for pharmacist consultations.
Requirements
 Must have one of the following active and unrestricted licensure/certifications: Pharmacy Technicians Certification Board (PTCB), State Board of Pharmacy Licensure in state of residence, ExCPT - Pharmacy Technician Certification with National Healthcareer Association (NHA), or The National Board of Prior Authorization Specialist.
,
 6+ months of Customer Service/Customer Relations experience with Healthcare professionals.
,
 Basic level of proficiency with Microsoft Excel, Microsoft Word, and Microsoft Outlook.
Nice-to-haves
 Knowledge of Call Center systems such as IEX.
,
 Strong communication skills, both written and oral, to improve Net Promoter Survey (NPS).
,
 Ability to follow through on tasks.
Benefits
 Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays + Floating Holiday.
,
 Medical Plan options along with participation in a Health Spending Account or a Health Saving account.
,
 Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage.
,
 401(k) Savings Plan, Employee Stock Purchase Plan.
,
 Education Reimbursement.
,
 Employee Discounts.
,
 Employee Assistance Program.
,
 Employee Referral Bonus Program.
,
 Flexible Work Arrangement.
,
 Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.). Apply Job! Ready for an Easy Start?This is a low-stress role with great rewards. If you're reliable and willing to learn, we want you. Apply now!
Apply Now
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The essential functions of a Pharmacy Technician in Prior Authorization are providing expertise and customer service support to members, customers, and/or providers. This position exists to take incoming requests for prior authorizations, for formulary and non-formulary medications, while ensuring a high level of customer service and maximizing productivity. Requests can be received via fax or telephone, from providers' offices and pharmacists. The position provides clinical review for authorizations in keeping with legal and contractual requirements, including but not limited to turn around times (TATs) and service level agreements (SLAs). The technician must provide the information clearly, accurately, and in a professional manner. Interactions with callers must be documented per contractual and various regulatory/legal requirements.
Responsibilities
 Answer prior authorization inbound calls (up to 50 to 70 calls per day) from providers/members and research and resolve formulary and benefit issues using appropriate reference material.
,
 Process authorizations through various computer systems and use job aids/policies/procedures ensuring the accuracy of all data and updating as necessary.
,
 Receive and process prior authorization requests made by providers and members for medications not inherently covered on a member's prescription drug plan using established criteria and guidelines.
,
 Ensure patient safety and quality of work, maintaining a safe and secure workspace and communicating with leadership when safety is compromised.
,
 Resolve issues and complaints in a timely manner.
,
 Perform other duties as assigned by management.
,
 Handle inbound phone requests and gather member data to provide information for pharmacist consultations.
Requirements
 Must have one of the following active and unrestricted licensure/certifications: Pharmacy Technicians Certification Board (PTCB), State Board of Pharmacy Licensure in state of residence, ExCPT - Pharmacy Technician Certification with National Healthcareer Association (NHA), or The National Board of Prior Authorization Specialist.
,
 6+ months of Customer Service/Customer Relations experience with Healthcare professionals.
,
 Basic level of proficiency with Microsoft Excel, Microsoft Word, and Microsoft Outlook.
Nice-to-haves
 Knowledge of Call Center systems such as IEX.
,
 Strong communication skills, both written and oral, to improve Net Promoter Survey (NPS).
,
 Ability to follow through on tasks.
Benefits
 Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays + Floating Holiday.
,
 Medical Plan options along with participation in a Health Spending Account or a Health Saving account.
,
 Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage.
,
 401(k) Savings Plan, Employee Stock Purchase Plan.
,
 Education Reimbursement.
,
 Employee Discounts.
,
 Employee Assistance Program.
,
 Employee Referral Bonus Program.
,
 Flexible Work Arrangement.
,
 Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.). Apply Job! Ready for an Easy Start?This is a low-stress role with great rewards. If you're reliable and willing to learn, we want you. Apply now!
Apply Now