Senior Pharmacy Technician

Senior Pharmacy Technician

Location: Raleigh NC

Job Type: 3 6 months

Job Description/Requirements

Performs reviews of prior approval requests submitted by enrolled providers. Escalates problems to appropriate personnel when needed. Performing under North Carolina's approved criteria that outlines policies and requirements this position determines prior approval for specific procedures. Answers incoming provider calls regarding prior approval request processing. Documents prior approval requests and associated history. Evaluates available information to validate prior approval requests. Verifies policyholder information, policy effective dates, premium status and verification of prior approval request eligibility. Sends prior approval request form to provider for updating, correction or completion. Investigates simple to moderately complex prior approval request and determines level or resolution if appropriate; advises provider of status; assists in negotiating settlement and resolution of prior approval request. Identifies need for additional information; contacts appropriate source to obtain needed information. Performs review of prior approval requests for pharmacy program

Required Skillset

All requirements of the labor category Licensed Pharmacy Technician Work Environment Office environment