Pharmacy Benefits Technician — Prior Authorization & Support (PT)

Health Plan; West Virginia; Hybrid; USD 17,000 - 25,000; Part time

Job summary

Health Plan in Wheeling, WV is seeking a Pharmacy Technician for a temporary part-time role. You will answer member and provider questions, assist pharmacists with drug coverage reviews, and process prior authorizations in a managed care environment.

The position requires a High School diploma or equivalent, 1 year of related experience, and strong typing (35 WPM) with Excel/office skills. On-site in Wheeling, with equal opportunity employment.

Qualifications

• High School diploma or equivalent required.
• Minimum 1 year experience in a retail, hospital, managed care or similar pharmacy setting.
• Typing speed of at least 35 WPM.
• Knowledge of pharmaceutical generics and trade names.
• Ability to follow established policies and procedures.
• Excellent verbal and written communication skills.
• Strong organizational and multi-tasking abilities.
• Experience performing medication authorizations in pharmacy or managed care.

Responsibilities

• Process medication coverage requests through prior authorization criteria and escalate when needed.
• Contact providers to obtain information for coverage requests.
• Attach policies to case documents for reviews.
• Document policy information before referral to Clinical Pharmacists or Medical Directors.
• Resolve coverage outcomes in PBM system and notify physicians or members.
• Research and respond to inquiries and grievances; document outcomes timely.
• Verify plan eligibility and applicable pharmacy benefits verbally.
• Update member information in PBM and medical review systems.

Skills

Typing speed

Pharmacy systems knowledge

Microsoft Excel

Communication skills

Organizational skills

Teamwork

Medication authorization knowledge

Policy and procedures comprehension

Education

High School diploma or equivalent

Health-related degree

Tools

Pharmacy computer systems

Microsoft Excel

Job description

Health Plan in Wheeling, WV is seeking a Pharmacy Technician for a temporary part-time role. You will answer member and provider questions, assist pharmacists with drug coverage reviews, and process prior authorizations in a managed care environment.

The position requires a High School diploma or equivalent, 1 year of related experience, and strong typing (35 WPM) with Excel/office skills. On-site in Wheeling, with equal opportunity employment.