The Associate Clinical Operations Technician is responsible for processing, communicating, documenting and tracking of requests for prior authorizations for delegated products and services. Commercial Clinical Review Book of Business-Help patients get the medication they need by reviewing rejected pharmacy claims. Fast-paced environment, highly collaborative, purposeful, high production, ability to be a self-starter, goal driven.
- 40-hour work week.
- Overtime can be required based on business needs.
- Possible WFH opportunity for tenured candidates.
- Weekend hours are highly possible. Candidates may receive a core schedule that includes a weekend day.
- Candidates should plan to work all holidays. Holiday hours based on business need.
Training Hours: ***Hours of training will not be their working hours***
8am - 4:30pm Monday – Friday CST/MT
Core business hours: 7am – 7pm CST/MT, candidates must be flexible to work an 8-hour shift within these hours and on weekends. Shifts will be decided after training.
Training Overview: 4 weeks of training learning the process in classrooms setting, two weeks of audits, and potential two additional weeks for audits if needed. There will be support from trainers and senior employees if they have questions as they go through cases while on the floor. Attendance is required during training.
Qualifications/years of experience:
- Computer background; working experience/known success working and navigating between different applications and/or learning new systems. (May use up to 8 different applications simultaneously per day)
- Quality and attention to details.
- Demonstrated organizational and time-management skills
- Basic math skills and general PC knowledge including Microsoft Office, Internet, and email.
- Process oriented and driven by metrics.
- Looking for someone who wants to grow.
- HIGHLY Preferred; Pharmacy Tech, PBM, Health Insurance experience.
- Candidate will utilize multiple different systems– dual monitors, toggling between screens.
- Systems that are utilized include; Cover My Meds, RxClaim, BET Website (Benefit Edit Tool), Right Fax, WebEx, Microsoft Office (Excel, Word, PowerPoint, Outlook).