Senior Prior Authorization Technician

Position Summary

Reviews verbal and electronic prior authorization requests based upon pre-established criteria and approves or recommends denial of authorization. Receives incoming calls daily from providers and/or patients seeking assistance. Makes outbound calls as needed. Data enters project specific information. Projects a professional company image through written and verbal interaction.

Essential Duties and Responsibilities

The essential functions include, but are not limited to the following:

Essential Functions:

• May approve, dismiss/early close or withdraw prior authorizations of medication according to guidelines as defined by the client.
• Answers incoming calls on a daily basis and in a timely manner. Assists callers with questions regarding approval or denial of medications. Research issues and resolves the issue. Document caller’s questions, issues, and resolution.
• Data enters information into the PAL/Client database. Corrects errors, if needed.
• Process requests for information (RFIs) for client accounts.
• Performs monitoring tasks of the PAL/Client database. Notifies management of errors and/or problems.
• Maintain compliance with all company policies and procedures.
• Willing to work flexible shifts, including nights, weekends and holidays.
• Perform related duties as assigned by supervisor.

Additional Responsibilities:

• Meet and/or exceed production, quality, attendance and adherence standards.
• Provide / assist in training other employees.
• Subject to fingerprinting and background screenings as required.
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Minimum Qualifications (Knowledge, Skills, and Abilities)

• High school diploma or GED equivalent is required, Bachelor’s degree from an accredited college/university preferred.
• Must be eligible for National certification from accredited source required, current National certification (PTCB) or (ExCPT), current State pharmacy technician license preferred.
• Minimum of 2 years of retail pharmacy and/or customer contact work experience, previous PBM or Prior Authorization data entry preferred.
• Basic reading, writing, and math skills required.
• Computer literate with the ability to learn customer service software applications.
• Professional verbal and written communication skills.
• Advanced keyboarding skills.
• Good attention to detail.
• Good problem-solving skills.
• Excellent customer service skills.
• Ability to work on multiple items at one time and meet deadlines.

TO ALL RECRUITMENT AGENCIES: The Company and its affiliates do not accept unsolicited agency resumes. Please do not forward resumes for any of our job postings, to our careers sites, or to any employees of the Company or its affiliates. We are not responsible for any fees related to unsolicited resumes.