Job Description & Responsibilities:
Primary Responsibilities: Primarily answering prior authorization with inbound calls (up to 50 to 70 calls per day) from providers/members as well as research and resolve formulary and benefit issues using the appropriate reference material Process authorizations through various computer systems and use of job aid/policies/procedures ensuring the accuracy of all data and updating as necessary Have sharp attention to detail, using established criteria and guidelines, the pharmacy technician receives and processes prior authorization requests made by providers and members for medications not inherently covered on a member’s prescription drug plan Patient Safety and Quality of work is paramount and it’s important for employees to have a safe and secure workspace and communicate with their leadership when that safety (equipment, system, information) is compromised Resolve issues and complaints in a timely manner Performs other duties as assigned by management Handles inbound phone requests and gathers member data to provide information for pharmacist consultations Training is for 5 weeks. Training time is 8:00am-5:00pm local time. Monday- Friday. This training time is subject to change Shift after training is an 8-hour shift with an hour lunch. Candidate must be available as early as 5am and as late as midnight Candidate will work 5 days a week which may or may not include a weekend day(s) There may be scheduled overtime and/or working on holidays dependent on business needs Candidate must have their own home internet access (internet can be hard wired with Ethernet cord) Candidate must also have a secure workspace/office in their home Candidate must have level skill with working with PC (ex. using mouse and keyboard, accessing, and navigating through multiple systems and screens) Excellent attendance is a must
Qualifications
Required Qualifications: Licensure Requirement – 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) The National Board of Prior Authorization Specialist 6 + months of Customer Service/Customer Relations with Healthcare professionals Basic level of proficiency with Microsoft Excel (ability to create, edit, and save a basic spreadsheet), Microsoft Word (ability to create, edit, and save a basic document), and Microsoft Outlook (ability to send emails) Ability to work any shift in the 5:00 AM to 12:00 AM timeframe with flexible hours, including OT and weekends
How To Apply:
Contact:
Employer: United Health Group
Location: Columbus, GA Remote
Link: https://careers.unitedhealthgroup.com/job/20329693/senior-pharm-pa-appeals-technician-remote-in-georgia-atlanta-ga/