Remote Prior Authorization Pharmacy Tech II

Elevance Health, Inc.; Ohio; Remote; USD 30,000 - 39,000; Full time

Job summary

Elevance Health, Inc. seeks a Prior Authorization Pharmacy Technician II in Mason, OH to interpret and data-enter moderately complex prescriptions, process prior authorizations, and troubleshoot adjudication issues.

The role supports hybrid/virtual work with required in-person training, requires an active license (as applicable), a high school diploma, and at least 2 years of pharmacy experience, plus strong communication and problem-solving skills.

Qualifications

• Active professional license if required by state law and Pharmacy Technician Certification as applicable
• HS diploma or equivalent with minimum of 2 years of pharmacy experience or equivalent education/experience
• URAC competencies include strong oral, written and interpersonal communication, problem-solving, facilitation, and analytical skills

Responsibilities

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

Skills

Oral and written communication

Interpersonal skills

Problem-solving

Facilitation skills

Analytical skills

Education

High School diploma or equivalent

Job description

Elevance Health, Inc. seeks a Prior Authorization Pharmacy Technician II in Mason, OH to interpret and data-enter moderately complex prescriptions, process prior authorizations, and troubleshoot adjudication issues.

The role supports hybrid/virtual work with required in-person training, requires an active license (as applicable), a high school diploma, and at least 2 years of pharmacy experience, plus strong communication and problem-solving skills.