Senior Pharmacy PA/Appeals Technician

Description

The essential functions of a Senior Pharmacy PA/Appeals Technician 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.

Position Schedule: Ability to work any shift from 5:00 AM to 12:00 AM timeframe with flexible hours, including OT and weekends

On-Call Schedule: On call schedule is every 3 weeks for 7 days in row, pay includes a flat daily rate whether called in or not & includes normal hourly rate if called in

If you reside within the states of Wyoming, you will enjoy the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

Manages a high volume of inbound and outbound calls, averaging 50+ daily
Answering Prior Authorization inquiry calls/requests with customer service skills as well as research, clinical information system utilizations and resolve formulary and benefit issues using the appropriate reference material
Process prior authorizations through multiple computer systems and use of job aids/policies/procedures ensuring the accuracy and compliance of all data and updating as necessary
Resolve issues and complaints in a timely manner
Handle inbound phone requests and gathers member data to provide information for pharmacist consultations

Tagged as: pharmacy technician

Requirements

Required Qualifications: Active and unrestricted Pharmacy Technician license in the state of Wyoming Active and unrestricted Pharmacy Technicians Certification Board (PTCB) OR ExCPT – Pharmacy Technician Certification with National Healthcareer Association (NHA) 6+ months of experience in 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) Currently located in the state of Wyoming Ability to work any shift from 5:00 AM to 12:00 AM timeframe with flexible hours, including OT and weekends and a rotating on call schedule every 3 weeks for 7 days in row

Benefits

Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays 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 Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: http://uhg.hr/uhgbenefits

Professional qualifications

  • Other coursework, licensures, and certifications

Job industry

  • Healthcare

Remote work

  • Wyoming

Pay amount

20-30/hour

Pay type

Hourly
UnitedHealth Group

Cheyenne, Wyoming (Remote)

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