Senior Pharmacy PA Appeals Technician - Remote in ME

Optum; San Jose (CA); Remote; USD 45,000 - 75,000; Full time

Job summary

An innovative healthcare organization is looking for a Senior Pharmacy PA Appeals Technician to enhance patient care through effective communication and technology. In this pivotal role, you'll manage prior authorizations, resolve claims issues, and ensure high-quality service in a dynamic, remote environment. The ideal candidate thrives on multitasking and possesses strong customer service skills. Join a forward-thinking team dedicated to health equity and diversity, where your contributions will make a significant impact on patient outcomes.

Qualifications

• Active and unrestricted National Certification or ability to obtain licensure within 180 days.
• Intermediate proficiency with computer applications.

Responsibilities

• Enter prior authorization and verify information accurately.
• Contact patients, pharmacists, and doctors to resolve claims issues.

Skills

Multitasking

Customer Service

Computer Applications

Communication

Education

National Certification (PTCB)

Tools

Pharmacy Software

Job description

Job Title: Senior Pharmacy PA Appeals Technician

Optum, a global organization committed to delivering healthcare through technology, is seeking a Senior Pharmacy PA Appeals Technician. This role involves managing incoming and outbound calls with patients, physicians, and pharmacists to ensure high-quality customer service and operational efficiency.

The position requires multitasking within multiple computer systems, responding to inquiries, and providing medication or clinical information in a fast-paced, high-volume environment. The role is primarily remote for residents of Maine, with flexibility to telecommute.

Primary Responsibilities:

1. Enter prior authorization and verify information accurately.
2. Contact patients, pharmacists, and doctors to resolve claims issues.
3. Process prior authorizations from intake to completion.
4. Resolve provider and customer issues, ensuring accurate communication.

Required Qualifications:

• Active and unrestricted National Certification (PTCB) or ability to obtain licensure within 180 days.
• Intermediate proficiency with computer applications and ability to learn new systems.
• Must be 18 years or older.

Preferred Qualifications:

• Experience with pharmacy or prescription data entry.

Additional details include salary range, benefits, and company mission focusing on health equity and diversity. All telecommuters must adhere to UnitedHealth Group's Telecommuter Policy. The company is an Equal Opportunity Employer and maintains a drug-free workplace.