Remote Pharmacy Tech I — PA & Data Entry

Elevance Health; California (MO); Remote; USD 25,000 - 41,000; Full time

Job summary

Elevance Health in California is seeking a Pharmacy Technician I (US) to interpret and data enter basic prescriptions, process prior authorizations, and troubleshoot adjudication issues. This role offers virtual full-time work with required in-person training sessions and occasional office visits within commuting distance.

You will verify member information, educate on prescription rules, handle formulary inquiries, and generate reports on rebates and utilization.

Qualifications

• Requires H.S. diploma or equivalent and minimum of 1 year of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
• Current State Pharmacy Tech. Certification or National Certification based on applicable state(s) required.

Responsibilities

• Verifies member information and inputs data for the pharmacists.
• Educates members on pharmacy-based rules related to prescriptions and medication resources or assistance programs.
• Processes prior authorization requests from physicians offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations.
• Provides resolution to grievances and appeals issues.
• Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
• Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports.
• Maintains record keeping of prior authorizations, rebates, and monthly reports.

Skills

Communication skills

Problem solving

Interpersonal skills

Analytical skills

Education

High School diploma or equivalent

State Pharmacy Technician Certification

National Certification

Job description

Elevance Health in California is seeking a Pharmacy Technician I (US) to interpret and data enter basic prescriptions, process prior authorizations, and troubleshoot adjudication issues. This role offers virtual full-time work with required in-person training sessions and occasional office visits within commuting distance.

You will verify member information, educate on prescription rules, handle formulary inquiries, and generate reports on rebates and utilization.