Pharmacy Technician
Posted on :
29-06-2024
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Job Description
Overview:
TekWissen Group is a workforce management provider throughout the USA and many other countries in the world. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family dental and vision plans for employers etc.
Title: Pharmacy Technician
Work Location: Detroit MI 48243
Duration: 6 Months
Job Type: Contract
Work Type: Hybrid (Yes the employee will need to be able to come onsite as needed but will work primarily remote (less than 1x/week)
Job Description
Dept: Pharmacy Help Desk Comm
Engagement Description:
- Support Client providers (pharmacists and physicians) with Medicare Part D and/or Commercial pharmacy/ specialty drug benefits analysis drug coverage inquiries and prior authorizations.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
- Answer telephones in an efficient and timely manner to lend appropriate assistance to providers
- Triage prior authorization requests under the supervision of a Clinical Pharmacist.
- Assists in maintaining pharmacy prior authorization criteria used in the adjudication of pharmacy/specialty claims.
- Analyzing written inquiries which lends to entry and updating of pharmacy authorizations into the claims system.
- Communicate coverage determination status to physicians and/or members and effectuate such decisions within the authorization tool.
- Troubleshoot problems inquiries and new processing procedures for coverage determinations.
- Assist with internal control systems and regulations compliance.
- Perform other related duties as assigned.
EDUCATION AND/OR EXPERIENCE
- High School Graduate of GED equivalent required. Two (2) years of college preferred.
- Two (2) years experience in retail or hospital Pharmacy required.
- Pharmacy Technician Certification (PTCB) preferred
- Knowledge of prescription drug names therapeutic classes and claims processing Experience with Medicare Part D prescription benefits may be preferred for some positions
QUALIFICATIONS
- To perform this job successfully an individual must be able to perform each essential duty satisfactorily.
- The requirements listed below are representative of the knowledge skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
OTHER SKILLS AND ABILITIES
- Expert knowledge of pharmacy claims processing
- Understanding of formularies and utilization management edits
- Familiarity with pharmaceutical manufacturers and product/cost information . Computer Literate (Microsoft Office Products).
TekWissen Group is an equal opportunity employer supporting workforce diversity.
Employment Type
Full Time
Key Skills
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