Remote-Eligible Prior Authorization Pharmacy Technician

Univera Healthcare; City of Albany (NY); Hybrid; USD 29,000 - 46,000; Full time

Job summary

Univera Healthcare is seeking a Pharmacy Benefits Specialist to review prior authorization requests, monitor formulary utilization, and assist physicians and pharmacists with questions regarding prescription initiatives. The role includes processing real-time authorization certifications for medications and supporting routine PBM interfaces.

Required are a health-related background and strong communication skills; a Pharmacy Technician certification (CPhT) or related background is preferred.

Qualifications

• High school diploma with at least two years in a health-related field.
• CPhT certification, LPN, Medical Assistant/Technologist background strongly preferred.
• Basic understanding of medical terminology and diagnosis codes.

Responsibilities

• Review of medical exception requests based on pharmacist-created algorithms.
• Review clinical documentation to determine approval of prior authorization requests.
• Assist with data entry and monitoring of member profiles for prior authorization.

Skills

Verbal communication

Written communication

Microsoft Office

Customer service

Problem solving

Independent work

Education

High school diploma

Associates degree preferred

Tools

Facets system

Job description

Univera Healthcare is seeking a Pharmacy Benefits Specialist to review prior authorization requests, monitor formulary utilization, and assist physicians and pharmacists with questions regarding prescription initiatives. The role includes processing real-time authorization certifications for medications and supporting routine PBM interfaces.

Required are a health-related background and strong communication skills; a Pharmacy Technician certification (CPhT) or related background is preferred.