Pharmacy Technician / Specialist | 100% Remote | Contract - Alpha Business Solutions
Newark, NJ 07105
About the Job
Our direct end client large healthcare / medical insurance provider is seeking to hire Pharmacy Technician(s) / Specialist(s) Level 1 for contract role to work 100% remote. No. of positions 04
Job Title: Pharmacy Specialist Level 1
Duration: 6 months +
Location: 100% Remote (client is in Newark, NJ)
Need active Pharmacy license in New Jersey, Registered as Pharma Technician in NJ OR PTCB Certification
High volume
Highly focused on outbound calling
125 cases / week
Productivity is tracked on weekly basis. Outbound calls may be recorded for quality & training.
Job Summary:
This position is responsible for receiving verbal and written requests for prior authorization from pharmacists, physicians and/or patients and is responsible for supporting and assisting in the coordination of Pharmacy Services activities including claim utilization analysis, prescription plan design, ad-hoc reporting, correspondence and special projects. Must maintain performance in compliance with organizational or department goals and in compliance with regulatory agencies
Responsibilities:
Process prior authorizations received via prior authorization help line, by evaluating the medical necessity/appropriateness for specific drugs and based on medical criteria.
Thanks,
Ashu
Job Title: Pharmacy Specialist Level 1
Duration: 6 months +
Location: 100% Remote (client is in Newark, NJ)
Need active Pharmacy license in New Jersey, Registered as Pharma Technician in NJ OR PTCB Certification
High volume
Highly focused on outbound calling
125 cases / week
Productivity is tracked on weekly basis. Outbound calls may be recorded for quality & training.
Job Summary:
This position is responsible for receiving verbal and written requests for prior authorization from pharmacists, physicians and/or patients and is responsible for supporting and assisting in the coordination of Pharmacy Services activities including claim utilization analysis, prescription plan design, ad-hoc reporting, correspondence and special projects. Must maintain performance in compliance with organizational or department goals and in compliance with regulatory agencies
Responsibilities:
Process prior authorizations received via prior authorization help line, by evaluating the medical necessity/appropriateness for specific drugs and based on medical criteria.
- Directly interact with members physician office staff, pharmacies and internal stake holders for eligibility, coverage determination claims issues.
- Conduct intervention with physician & pharmacy office staff to facilitate formulary compliance and generic dispensing.
- Process appeals complaints executive inquiries and compliance related issues.
- Provide recommendations to increase efficiency, accuracy and productivity in the department.
- Process ad hoc request for information or reports from stakeholders.
- Participate in client member and employee training to ensure practical understanding of pharmacy services programs and operations.
- Assist in the day to day business functions of the pharmacy department as well as the Medication Therapy Management program.
- Provide support to various clinical programs within the pharmacy department.
- Prefers a Bachelor's degree from an accredited college or university in Health Care Management, Business or Pharmaceutical Administration.
- Requires minimum of two (2) years experience in third party prescription program claim adjudication.
- Requires minimum of two (2) years experience as a Pharmacy Utilization Management Specialist.
- Requires prior customer service/service quality initiative experience.
Thanks,
Ashu
Source : Alpha Business Solutions