Tech I Prior Auth

We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.

The Tech I Prior Auth takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the criteria based prior authorization process.

Responsibilities:

• Effectively manage work volume by handling inbound calls/fax/ePA requests utilizing appropriate courteous and professional behavior based upon established standards (40%).
• Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers (40%).
• Communication with other internal groups regarding determination status and results (seniors, pharmacists, appeals, etc) (10%).
• Identify and elevate clinical inquiries to the pharmacist team as appropriate (5%).
• Other duties assigned, for example faxes, sorting, email boxes, CAS maintenance, etc (5%).

Requirements:

• 6+ months of Customer Service/Pharmacy Technician Experience
• Basic computer skills, Microsoft Office Suite: Excel and Word required; Access, Outlook, PowerPoint, Visio preferable
• Keyboard skills essential
• Multitasking and utilizing multiple system applications simultaneously
• Basic pharmaceutical knowledge pertaining to terminology, calculations, and protocols
• Excellent written, verbal, grammar, and listening communication skills
• Ability to maintain confidentiality of PHI (Protected Healthcare Information)

Benefits:

• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources, based on eligibility