Job Description

Will this position be required to work onsite for any reason at any time? Only required to go onsite if IT issues where they have to bring in their laptop or if they have an outage that lasts more than one day.

This is a fully remote position, but would prefer candidates be from Michigan, southeast area or south of Flint

The pharmacy technician will assist in providing pharmacy services. Other related skills may be required to perform this job.

Qualifications:

High school diploma or GED. One year pharmacy experience working under a license pharmacist or completion of certified pharmacy technical program. Working knowledge of third-party claims process. Please see job description for a more thorough listing of requirements for this position.

Engagement Description – PA Specialist in Pt B Pharmacy will support providers (physicians and other healthcare providers rendering medical care) with Medicare Part B drug coverage inquiries, and prior authorizations.

Top 3 Required Skills/Experience –

• 2-4 years Specialty and/or Retail Pharmacy

• Experience in provider/member call center or helpdesk

• Process prior authorization requests

Required Skills/Experience – The rest of the required skills/experience. Include:

• Knowledge of specialty prescription drug names, NDC drug codes, therapeutic classes and claims processing preferred

• Call Center or Helpdesk experience. Ability to communicate effectively with providers and members.

• Analyzing written, faxed, and verbal inquiries which may lead to entry of medical authorizations into the online provider facing webtool.

Preferred Skills/Experience – Optional but preferred skills/experience. Include:

• Prior Authorization on Pt B specialty medications

• Knowledge or pricing NOC drugs

• Familiarity with Medicare Guidelines and Timeframes

• Knowledge of pharmacy and/or medical claims processing

• Proficient in Microsoft Office Products

Education/Certifications – Include:

• High School Graduate of GED equivalent required. Two (2) years of college preferred.

• Pharmacy Technician Certification (PTCB) preferred

Work Environment

This position is fully remote. There may be some occasional requirement to work in Southfield or South Lyon location if internet or system issues prevent candidate from working in their remote location. This position is with a Pharmacy Helpdesk with incoming and outgoing calls from both members and providers and therefore candidate should have a designated workspace that is free from noise and disruptions. Additionally, workspace would have to be conducive to protecting PHI.

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