Remote Prior Authorization Pharmacy Tech II

Elevance Health, Inc.; Miami (FL); Hybrid; USD 38,000 - 48,000; Full time

Job summary

Elevance Health is seeking a Prior Authorization Pharmacy Technician II who will be responsible for interpreting and data entry of moderately complex prescriptions, processing prior authorizations, and resolving adjudication issues. The role requires active licensure (where required) and a strong understanding of Medicare guidelines.

In this position, you will verify member information, educate members about prescription benefits and resources, handle inquiries from physicians and the sales

Qualifications

• Active license or certification as required by state law to practice as a Pharmacy Technician.
• H.S. diploma or equivalent with minimum 2 years of pharmacy experience, or equivalent experience.
• Strong data entry, communication, and problem-solving skills to support prior authorization processing.

Responsibilities

• Verifies member information and inputs data for pharmacists.
• Educates members on pharmacy rules related to prescriptions and assistance programs.
• Processes prior authorization requests from physician offices and ensures Medicare compliance; informs relevant parties of determinations.
• Provides resolution to grievances and appeals issues.
• Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
• Maintains record keeping of prior authorizations, rebates, and monthly reports.

Skills

Data entry accuracy

Member education

Interpersonal communication

Education

High School diploma or equivalent

State Pharmacy Technician Certification or National Certification

Job description

Elevance Health is seeking a Prior Authorization Pharmacy Technician II who will be responsible for interpreting and data entry of moderately complex prescriptions, processing prior authorizations, and resolving adjudication issues. The role requires active licensure (where required) and a strong understanding of Medicare guidelines.

In this position, you will verify member information, educate members about prescription benefits and resources, handle inquiries from physicians and the sales