Pharmacy Prior Authorization Specialist I

TALENT Software Services; Philadelphia (Philadelphia County); Presencial; USD 42.000 - 48.000; Jornada completa

Descripción de la vacante

TALENT Software Services seeks a Prior Authorization Technician I to process requests from providers, members, and pharmacies. You will interpret clinical criteria, utilize claim history, and collaborate with pharmacists when needed.

The role requires knowledge of specialty and non-specialty pharmaceuticals, with strong keyboarding skills and the ability to multitask in a fast-paced healthcare environment. Weekend/holiday availability is expected.

Formación

• 1–3 years in a PBM, managed care, or pharmacy role.
• Certified Pharmacy Technician with valid credential (PTCB or NHA).
• Typing speed of at least 35 words per minute.

Responsabilidades

• Process prior authorization requests from providers, members, and pharmacies.
• Interpret clinical criteria and approve requests when applicable.
• Contact for additional information to complete reviews; submit authorizations.
• Forward requests to pharmacists or in-network providers as needed.
• Assist in Appeals processing and related tasks as assigned.
• Maintain productivity and quality across multiple tasks and systems.

Conocimientos

Experience: 1-3 years

PBM/Managed care exposure

Typing 35 wpm

Educación

High School Diploma or GED

PTCB or NHA Certification

State license/certification as required

Descripción del empleo

TALENT Software Services seeks a Prior Authorization Technician I to process requests from providers, members, and pharmacies. You will interpret clinical criteria, utilize claim history, and collaborate with pharmacists when needed.

The role requires knowledge of specialty and non-specialty pharmaceuticals, with strong keyboarding skills and the ability to multitask in a fast-paced healthcare environment. Weekend/holiday availability is expected.