Job Title: Pharmacy Technician

Job Description

Hiring Technicians for Appeals department! This is not traditional CDPA Review - this is Medical Authorizations, a lot of injectables done at the doctor's office. Not traditional prescription authorizations. Mostly a data entry position, some outbound phone work to call doctors or members. You will be reviewing rejected Prior Authorizations that have gone to appeal. This is Technicians Review, where you will review the cases that were rejected. You may call doctor's offices and members to gather more information. You may get some inbound calls from those doctor's offices and members if they call back. You will log into the CPS Compass and UMV systems, as well as the Express Scripts platform. You will access the department’s inbound fax queue, select the earliest available fax, and build/intake the appeal or reimbursement request from the information provided on the fax into the member account in the Compass system and/or review Pharmacy Appeals or Reimbursement cases and review against plan criteria. You will also be required to make outreach to provider’s offices and members to obtain additional information needed to review cases.

Hard Skills

• Pharmacy Technician License
• Computer skills
• Microsoft Office

Job Type

This is a Contract-to-Hire position with a duration of 6 Month(s).

Work Site

This is a fully remote position.

Work Environment

100% Remote, in a quiet and closed door setting, must have strong wifi. Monday-Friday: 8am-8pm in their time zone. Most likely going to be a 10-6:30pm shift after training; M-F, weekend rotations - available Sat/Sun every 4-6 weeks, and could be working a holiday. Would not be working the Holidays this year. Training is 4 weeks long- Monday - Friday 10-6:30pm EST. Shifts will be 10-6:30 in their time zone.