Prior Authorization Specialist II

WellDyne; United States; Remote; USD 28,700 - 40,900; Full time

Benefits offered by this job

Medical, Dental and Vision Benefits

401K after 90 days of employment

Employee Assistance Program

Educational Reimbursement

Paid Time Off

Job summary

WellDyne is seeking a Prior Authorization Tech II to initiate clinical PA requests by phone or email, create and fax cases, and document all activity with accuracy. You will also complete PA requests via telephone with prescriber staff and work closely with pharmacies, providers, and members to resolve issues.

In this role you will uphold confidentiality, maintain PHI compliance, and strive for productivity and high-quality service while using MS Office tools and handling multiple tasks in a

Qualifications

• Pharmacy technician certification preferred or plan to obtain PTCB within 6 months.
• Active technician registration as required by state regulations.
• Minimum 2 years of pharmacy-related experience.
• Minimum 2 years of customer service experience.

Responsibilities

• Start clinical prior authorization requests via telephone or email.
• Support PA call center via administrative and clinical PA lines.
• Create and fax cases for PA with complete, timely documentation.
• Complete PA requests via telephone with prescriber office staff.
• Collaborate with pharmacies, providers, and members to resolve PA questions.
• Respond promptly to inquiries with professionalism and courtesy.
• Identify and resolve problems per established procedures.
• Handle difficult situations and resolve matters timely.
• Clear and follow up on PA voicemail messages.
• Apply policies and eligibility/benefit rules.
• Maintain PHI confidentiality per state and federal law.
• Meet productivity, schedule adherence, and quality standards.

Skills

Telephone communication

Verbal communication

Written communication

Time management

Customer service

Detail oriented

Multi-tasking

Education

Pharmacy Technician Certification

PTCB Certification within 6 months

Active technician registration

Tools

MS Office Suite

Job description

WellDyne is seeking a Prior Authorization Tech II to initiate clinical PA requests by phone or email, create and fax cases, and document all activity with accuracy. You will also complete PA requests via telephone with prescriber staff and work closely with pharmacies, providers, and members to resolve issues.

In this role you will uphold confidentiality, maintain PHI compliance, and strive for productivity and high-quality service while using MS Office tools and handling multiple tasks in a