Pharmacy Authorization Technician

Pharmacy Authorization Technician

We're seeking a Pharmacy Authorization Technician to work at a leading healthcare organization in Greece, NY. With us, it's all about finding the job that's just right.

Pay Rate: $20.00 per hour (Contract for 6-8 months) REMOTE position, but must live in the area

Shift: 8am-5pm, Monday-Friday with availability to work 1-2 weekends during 6-8 month contract assignment

What's a typical day as a Pharmacy Authorization Technician? You'll be:

• Performing initial processing and review of pharmacy and medical specialty drug authorization requests in accordance with established policies.
• Preparing, interpreting, and documenting cases for utilization management (UM) reviews and determinations.
• Acting as a subject matter expert for applications and systems used in the authorization process.
• Serving as a resource for staff regarding member-specific contract benefits, policies, and procedures.
• Conducting medication authorization, exception, and medical necessity reviews to determine coverage and routing cases for final determination as needed.
• Issuing verbal and written notifications to members.
• Reviewing prescription and medical benefit coverage, documenting medication histories, and identifying missing information to assist clinical staff.
• Communicating with pharmacies, physician offices, and internal staff to clarify authorization requests and facilitate the review process.
• Troubleshooting for the pharmacy help desk, customer care, and claim processors regarding pharmacy and medical claims.
• Performing system testing for upgrades and enhancements to care management systems.
• Triaging authorization workflows and providing phone support for incoming calls related to UM processes.

This job might be an outstanding fit if you:

• Have experience or training in pharmacy operations, healthcare administration, or a related field (required).
• Possess strong attention to detail and the ability to interpret medical and pharmacy benefit information.
• Are comfortable working with multiple systems and acting as a content expert.
• Demonstrate excellent communication and customer service skills.
• Can prioritize and triage tasks to meet compliance deadlines.
• Are adept at problem-solving and collaborating with clinical and administrative staff.
• Previous experience with utilization management or pharmacy authorization processes is preferred.

Once you apply, you'll proceed to next steps if your skills and experience look like a good fit. But don't worryeven if this position doesn't work out, you're still in our network. That means all of our recruiters will have access to your profile, expanding your opportunities even more.

Helping you discover what's next in your career is what we're all about, so let's get to work. Apply to be a Pharmacy Authorization Technician today!