Senior Pharmacy PA & Appeals Technician (Remote)

UnitedHealth Group; Sugar Land (TX); À distance; USD 25 000 - 44 000; Plein temps

Avantages offerts par ce poste

Paid Time Off

Medical Plan

Dental & Vision

Life & AD&D Insurance

401(k) Savings Plan

Education Reimbursement

Employee Discounts

Employee Assistance Program

Employee Referral Bonus Program

Voluntary Benefits

Résumé du poste

UnitedHealth Group in the United States is seeking a Senior Pharmacy PA/Appeals Technician to support prior authorization and appeals, handling requests through phone, fax, and electronic systems. The role requires meticulous review of member, provider, medication, diagnosis, and benefit details, with escalation to a pharmacist when needed, in a telecommuter-friendly setup.

Candidates must hold active pharmacy technician licensure and be able to work a flexible schedule, with strong Excel/Docs

Qualifications

• Active and unrestricted Pharmacy Technician licensure in the state of residence.
• 6+ months of experience in customer service or healthcare setting.
• Proficiency with Excel, Word, Outlook and Teams.
• Ability to navigate multiple systems during calls and case processing.
• Flexibility to work within 5:00 AM–12:00 AM shifts as required.

Responsabilités

• Handle a high-volume of inbound and outbound calls (50+ daily) with professionalism and accuracy.
• Respond to prior authorization inquiries from providers, pharmacies, members and internal partners.
• Review and process prior authorization requests across multiple computer systems with complete documentation.
• Research formulary, benefit, medication, eligibility and plan details to resolve PA questions.
• Gather and verify member, provider, prescriber, pharmacy, medication, diagnosis and clinical data.
• Identify missing information and route to pharmacist or clinician when needed.
• Prioritize work to meet turnaround times and SLA requirements.
• Maintain documentation standards and compliance in a fast-paced environment.

Connaissances

Customer service

Microsoft Excel

Microsoft Word

Microsoft Outlook

Microsoft Teams

Multitasking

Formation

Pharmacy Technician licensure

PTCB certification

State licensure/registration

ExCPT certification

Description du poste

UnitedHealth Group in the United States is seeking a Senior Pharmacy PA/Appeals Technician to support prior authorization and appeals, handling requests through phone, fax, and electronic systems. The role requires meticulous review of member, provider, medication, diagnosis, and benefit details, with escalation to a pharmacist when needed, in a telecommuter-friendly setup.

Candidates must hold active pharmacy technician licensure and be able to work a flexible schedule, with strong Excel/Docs