Clinical Pharmacy Technician

Phoenix, AZ

Post Date: 08/14/2017 Job ID: 23065 Category: Pharmacy

Shift:
  • Must be available to work any shift from 9am-8: 30pm Monday-Sunday.
  • Will have two days off.

Job Description:
  • Candidates will be taking inbound calls in a high volume call center.
  • Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.

Essential Functions:
  • 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.

Qualifications:
  • Ability to identify and trouble-shoot problematic issues.
  • Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
  • In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).
  • Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
  • Excellent written and verbal communication skills.
  • Ability to follow clinical criteria and instructions to approve prior authorization requests.
  • Minimum of 6 months dispensing or retail experience required, or equivalent internal training will be substituted.
  • Ability to identify and trouble-shoot problematic issues.

Requirements/Certifications:
  • CPT Certification/licensure in accordance with state requirements.
  • PTCB National Certification required.

A-Line Staffing Solutions

877-782-3334

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