The Tech I Prior Auth takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team.
The Tech I will also assist with other duties as needed to include but not limited to outbound calls, reviewing and processing Prior Auth’s received via fax and ePA, monitoring and responding to inquiries via department mailboxes and other duties as assigned by the leadership team.
Responsibilities:
Effectively manage work volume by handling inbound calls/fax/ePA requests utilizing appropriate courteous and professional behaviour based upon established standards.
Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers.
Communication with other internal groups regarding determination status and results (seniors, pharmacists, appeals, etc).
Identify and elevate clinical inquiries to the pharmacist team as appropriate
Other duties assigned, for example faxes, sorting, email boxes, CAS maintenance, etc.
Experience:
0 to 3 years of related work experience.
Skills:
Prior Authorization
Call handling experience.
Education:
High School diploma or GED
Active pharmacy tech license required of the state they resist.
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com.
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Health Care Provider
Industries
IT Services and IT Consulting, Software Development, and Financial Services
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