- Determines appropriateness for medications. Communicates decision to physicians, physician?s office staff, medical management staff and/or pharmacists.
- Researches, resolves and documents prior authorization outcomes in pharmacy system.
- Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician?s office staff, medical management staff and/or pharmacists.
- Escalates requests to Pharmacist when request requires extensive clinical review or denial.
- Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.
- Performs other duties as required.
Requirements/Certifications:
- CPT - Certified Pharmacy Technician - Pharmacy - REQUIRED
- PTCB - Pharmacy Technician Certification – Pharmacy
Experience: At least 2+ years in retail, hospital or facility pharmacy setting
Computer Skills: Must be PC literate and able to pay close attention to crucial detail. Ability to type 40 wpm. Candidate will be working on dual monitors in multiple systems so he/she must be able to multitask.
Typical Days:97% in-bound calls, 50-60 calls/day that are clinical and non-clinical