Pharmacy Technician - Prior Authorizations - Work From Home
Hispanic Alliance for Career Enhancement, Lansing, MI, United States
Position Summary
Processes prior authorization requests received by phone, fax, or electronically and utilizes various computer resources, existing criteria, and medication guidelines to perform clinical research to support prior authorization reviews.
Proactively completes prior authorization approvals and denials that are due to expire and maintains complete, timely, and accurate documentation.
Reviews potential prior authorization denial language to ensure NCQA requirements are met.
Follows prior authorization workflow, policies, and procedures during the course of the workday.
Answers a high volume of prior authorization inquiry calls from provider offices, pharmacies, and internal partners using various computer resources to communicate status or decisions.
Maintains a balance of productivity, quality, and timeliness of work.
Participates in training and continuing education as required.
Participates in team/departmental meetings as required.
Ensures excellent attendance.
Uses strong drug name and diagnosis pronunciation, recognizes medical terminology, and navigates multiple computer resources to document conversations and decisions.
Possesses good written and verbal communication skills.
Hours of Operation
Shifts occur between 5:00 am and 8:30 pm; overnight shifts may also be available but are not guaranteed.
Full-time employees work 40 hours per week, including potential weekend and holiday work.
Rotating weekend schedule may be required.
Candidates must have personal home internet access with a minimum speed of 100 Mbps download (wired Ethernet acceptable) and a secure workspace.
High level of PC proficiency is required (mouse, keyboard, multi‑system navigation).
Required Qualifications
National Pharmacy Technician certification and an Arizona or applicable state Pharmacy Technician license, current and in good standing.
Between 1–5+ years of Pharmacy Prior Authorization processing experience.
Ability to multi‑task and prioritize work.
Ability to adjust based on business or department needs.
Good organizational skills.
Preferred Qualifications
Retail or Hospital experience.
Managed Care or Medicaid experience.
AS400 experience.
Proficiency in using computerized resources and software applications.
Proficiency with Microsoft applications (Excel, Word, Outlook).
Knowledge in pharmacy practices, procedures, and ability to read and understand clinical information.
Working knowledge of drug dosage forms, drug strength, generic and brand name equivalents.
Education
High School diploma, G.E.D.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
$18.50 – $35.29 per hour
This range represents the base hourly rate for the job grade; the actual offer will depend on experience, education, geography, and other factors. The position is eligible for additional bonuses, commissions, or short‑term incentive programs.
Benefits
This full‑time position is eligible for a comprehensive benefits package that supports the physical, emotional, and financial well‑being of employees and their families. Benefits include medical, dental, and vision coverage; paid time off; retirement savings options; wellness programs; and other resources based on eligibility.
EEO Statement
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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Processes prior authorization requests received by phone, fax, or electronically and utilizes various computer resources, existing criteria, and medication guidelines to perform clinical research to support prior authorization reviews.
Proactively completes prior authorization approvals and denials that are due to expire and maintains complete, timely, and accurate documentation.
Reviews potential prior authorization denial language to ensure NCQA requirements are met.
Follows prior authorization workflow, policies, and procedures during the course of the workday.
Answers a high volume of prior authorization inquiry calls from provider offices, pharmacies, and internal partners using various computer resources to communicate status or decisions.
Maintains a balance of productivity, quality, and timeliness of work.
Participates in training and continuing education as required.
Participates in team/departmental meetings as required.
Ensures excellent attendance.
Uses strong drug name and diagnosis pronunciation, recognizes medical terminology, and navigates multiple computer resources to document conversations and decisions.
Possesses good written and verbal communication skills.
Hours of Operation
Shifts occur between 5:00 am and 8:30 pm; overnight shifts may also be available but are not guaranteed.
Full-time employees work 40 hours per week, including potential weekend and holiday work.
Rotating weekend schedule may be required.
Candidates must have personal home internet access with a minimum speed of 100 Mbps download (wired Ethernet acceptable) and a secure workspace.
High level of PC proficiency is required (mouse, keyboard, multi‑system navigation).
Required Qualifications
National Pharmacy Technician certification and an Arizona or applicable state Pharmacy Technician license, current and in good standing.
Between 1–5+ years of Pharmacy Prior Authorization processing experience.
Ability to multi‑task and prioritize work.
Ability to adjust based on business or department needs.
Good organizational skills.
Preferred Qualifications
Retail or Hospital experience.
Managed Care or Medicaid experience.
AS400 experience.
Proficiency in using computerized resources and software applications.
Proficiency with Microsoft applications (Excel, Word, Outlook).
Knowledge in pharmacy practices, procedures, and ability to read and understand clinical information.
Working knowledge of drug dosage forms, drug strength, generic and brand name equivalents.
Education
High School diploma, G.E.D.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
$18.50 – $35.29 per hour
This range represents the base hourly rate for the job grade; the actual offer will depend on experience, education, geography, and other factors. The position is eligible for additional bonuses, commissions, or short‑term incentive programs.
Benefits
This full‑time position is eligible for a comprehensive benefits package that supports the physical, emotional, and financial well‑being of employees and their families. Benefits include medical, dental, and vision coverage; paid time off; retirement savings options; wellness programs; and other resources based on eligibility.
EEO Statement
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
#J-18808-Ljbffr