ob Title: Pharmacy Technician
Location: Tempe, AZ 85281
Schedule: Shifts varies- 8 hr. shift between 8:00AM - 9:00 PM
30 DAY Training Schedule: M-F 8AM-5PM
Compensation: $18.50 /hrly
Environment: Business Office Environment
Experience & Requirements:
- Pharmacy Technician License
- Requires National Certification and State License
- Excellent verbal and written communication and interpersonal skills
- Ability to learn new processes and systems quickly
- Strong time management and organization skills
- Strong research and analytical and problem solving skills
- Ability to work independently
- Ability to work in rapidly changing environment
Formulary Management Duties:
- Reviews and processes formulary change requests from Health Net plans
- Submits and maintains formulary change requests to Health Net's pharmacy claims processor
- Generates, maintains and reviews Formulary Status Grids
- Uses reports to perform audits and quality checks on the current formulary status for accuracy and contract compliance
- Assists Clinical Pharmacist with formulary database maintenance and updates to company website
Pharmacy Audit and Recovery:
- Performs a variety of assignments required for pharmacy audit and recovery functions.
- Reviews paid claims for quantity and/or billing discrepancies. Corresponds with pharmacies as needed to communicate review finding.
- Faxes inquiries to pharmacies related to review findings
- Answers in-coming calls and responds appropriately to faxed correspondence from pharmacies
- Updates Access database with incoming phone calls, faxes and emails
Pharmacy Services Center:
- Takes member inquiry calls for benefit questions including prior authorization requests
- Maintains expert knowledge on all Health Net Medicare Pharmacy benefits and formularies, including CMS regulations as they pertain to this position.
- Educates the member on their specific pharmacy benefit and offers them options including the submission of a prior authorization request.
- Process members submitted claims
Prior Authorization Duties:
- Reviews requests made by physicians and pharmacies for use of prescription drugs that are non-formulary, have prior authorization requirements, have exceeded quantity or cost limits, or require assistance in on-line processing of a prescription claim.
- Assign, enter and document prior authorizations into appropriate claims processing systems.
- Answer phone calls for prior authorization inquiries
- Research and resolve issues using the appropriate reference material.
- Responsible for knowing and interpreting pharmacy and medical benefits.
- Medicare Part D Operations
- Reviews and processes PDE files
- Researches and resolves issues using the appropriate reference material
- Assists in pharmacy claims corrections projects
- Performs audits and quality checks on active prior authorizations claims
- Assists with identifying and correcting eligibility and group issues & Processes member claims
Position Notes: This is a long term, contract-to-hire position. Medix offers weekly pay, with health insurance benefits (medical/dental/vision insurance, 401k, PTO) through Medix after 30 days of full time employment.
"Medix cares about its employees to the point where they're treated like family. They provide the necessary tools to help with your job search and provide continuous contact to ensure your placement is going well and follow up with any questions or concerns. You're more than just an employee- you're also a team member, and I couldn't be happier!" - JASMINE, MEDIX TALENT
Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?
Why Work Here?Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine. Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?
Work with a fast growing, purpose-driven, organization that fosters development and growth opportunities!