Clinical and Technical Call Center Pharmacy Technician

Pharmacy TechnicianThe Pharmacy Technician for the PBM clinical and technical call center is expected to be a subject matter expert in areas of pharmacy knowledge as well as call center operations. Duties will include, but are not limited to, answering incoming calls and making outgoing calls for members, medical providers, or pharmacy providers, appropriate processing of prior authorization requests, and assisting members and providers with inquiries through other media platforms as needed (fax, web, e-mail).Responsibilities:Remain compliant with all PHI protocols and requirements including the handling of company confidential data according to policy and guidelines. Adheres to existing security policies and procedures.Process submitted prior authorization requests within the required time frame mandated by the State clientCompletion of approval process for prior authorizations where all criteria is met and clinical judgement of a pharmacist is not requiredComplete necessary communication with providers regarding status of their authorization submission or any other inquiriesFollow standard operating procedures to receive incoming calls and use learned knowledge and resources to resolve the call on initial contactProvide a positive experience when communicating with members and providersComplete outreach to providers to obtain information when requiredAppropriately document all inquiries received via phone, fax, or email for members or providersProvide a high level of customer care with our members and providersMeet all department requirements, goals, and performance expectationsComplete all tasks assigned within regulatory guidelinesActively identify areas of inefficiencies and provide innovative suggestions to leadership to keep processes currentDevelops understanding of the client's business and applies knowledge to support efficient procedures and adherence to service level agreements.Performs standard, recurring processing and quality tasks in support of outsourced services within a specific industry and functional area. Demonstrates knowledge and skill in assigned work processes.Complete any additional job-related tasks as requestedSkills:Strong verbal and written communication skillsBalance's accuracy, quality, and efficiency in all tasksA willingness and ability to learn internal systems/processes/programs, as neededBasic math skillsFamiliarity with medication names and medical terminologyGeneral computer knowledge including Microsoft Office, use of the internet, and email is requiredAbility to learn quickly, solve problems, and make decisions with minimal supervisionAbility to adapt and work collaboratively in a fast-paced, production environmentWillingness to work a flexible schedule to accommodate peak volume timesExcellent attention to detailEffective communication skills with internal and external clients, verbally and writtenKnowledge of pharmacy insurance claimsOrganization skills to balance and prioritize workAbility to multi-taskAbility to work independently and as part of a teamRequirements:Must be at least 18 years of ageHigh school diploma or GED requiredActive pharmacy technician registration with a Board of Pharmacy or certified pharmacy technician from accredited program (PTCB, ExCPT, etc.) or must obtain certification within 12 months2 years of relevant experience as a pharmacy technician in retail pharmacy, hospital pharmacy, managed care, insurance, or pharmacy benefit management