Call Center Clinical Pharmacy Technician (Remote)

Call Center Clinical Pharmacy Technician (Remote) Performs the basic duties of a pharmacy technician in all designated sites. Including and not limited to, prescription data entry, as well as communicate and coordinate with all parties necessary to insure timely shipping and delivery of prescription orders. Pulls and labels medication for pharmacist verification. Packs medications appropriately and affixes a shipping label after the order has been verified by a pharmacist. Performs all basic duties of a pharmacy technician allowable by legal licensure and registration.

• You will be evaluating and authorizing approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.
• Clinically reviews coverage determinations with attention to detail, for medications via Fax. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists within SLA (service level agreement) guidelines.
• You will determine appropriateness for medications and communicate decision to physicians, physician`s office staff, medical management staff and/or pharmacists.
• You will research, resolve and document prior authorization outcomes in pharmacy system.
• You will escalate requests to Pharmacist when request requires extensive clinical review or denial.
• You will perform other duties as required.
• You must be available to work a set schedule during training and must be available and commit to work any assigned shift between the hours of 8AM and 10PM ET daily including weekends and holidays.
• For CPTs assigned to work the fax queue, responsibilities will also include:
• Efficiently multi-tasks and monitors several queues and assignments. Adapts to team requirements as business needs change (e.g., fax work, pending queues, oral notifications, and failed faxes).
• Your performance measurements include quality, average handle time, productivity metrics, schedule adherence, and behavioral competencies.
• As a Call Center Clinical Pharmacy Technician working remotely, you will be responsible for high volume inbound call center serving calls from Members, Pharmacies and Prescribers for Medicaid/Medicare or commercial pharmacy benefits management business.
• You will communicate selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists.
• You will research, resolve and document physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.

• Pharmacy technician experience in prescription entry, picking, labeling and preparing medication orders for pharmacist verification.
• Ability to identify and trouble-shoot problematic issues.
• Excellent written and verbal communication skills.
• In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT).
• Must have pharmacy intern license as required by applicable state laws OR:
• Must have an active pharmacy technician licensure or registration in accordance with state requirements.
• If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT).
• Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
• Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.

Pharmacy GED, High School CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy - Pharmacy, Pharmacy Intern - Pharmacy - Pharmacy