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
• Investigate 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