Remote Prior Authorization Pharmacy Tech Medicare/Medicaid

Actalent; St. Louis (MO); À distance; USD 28 000 - 30 000; Plein temps

Résumé du poste

Actalent seeks a dedicated Pharmacy Technician to work with Medicare and Medicaid patients, focusing on prior authorizations in the MedPharm environment. The role includes intake and technical review functions and is based out of St.

Louis, MO with 100% remote work. Responsibilities include handling PA intake, tech review, and deciding on coverage, while maintaining HIPAA-compliant service and strong customer interactions over the phone.

Qualifications

• Pharmacy Technician certification.
• Experience in data entry and managed care.
• Prior Authorization processing.
• Proficiency in customer service and handling claims.
• Strong computer skills.
• Ability to work independently and remotely.

Responsabilités

• Handle the intake of MedPharm prior authorizations, setting them up in the system and forwarding to the review technician.
• Conduct Tech Review by receiving PA cases from the intake team and reviewing them to determine coverage.
• Approve or deny medications based on clinical determinations and eligibility criteria.
• Read and interpret criteria, SOPs, insurance documents, and medical documents to make informed decisions.
• Provide excellent customer service over the phone, managing conversations and redirecting when necessary.

Connaissances

Data entry

Managed care

Prior Authorization

Customer service

Strong computer skills

Remote work ability

Formation

Certified Pharmacy Technician (Cpht) certification

Description du poste

Actalent seeks a dedicated Pharmacy Technician to work with Medicare and Medicaid patients, focusing on prior authorizations in the MedPharm environment. The role includes intake and technical review functions and is based out of St.

Louis, MO with 100% remote work. Responsibilities include handling PA intake, tech review, and deciding on coverage, while maintaining HIPAA-compliant service and strong customer interactions over the phone.