Job description

Overview:

Our client, is a diversified pharmacy solutions organization serving health plans, employers and government programs, seeks an accomplished Certified Pharmacy Technician.

*** Candidate must be authorized to work in USA without requiring sponsorship ***

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*** Location: San Diego, CA (100% Remote acceptable)

*** Duration: 6 months contract w/ possibility of extension

Important Notes:

· Strict Start Date: 02/27/2023.

· NO Time-Off policy by client during Training period i.e., first 3 – 5 weeks.

· Candidate MUST have high-speed wired internet connection. Wi-Fi / Wireless connections not allowed as a violation of policy and can lead to breach of Private Health Information (PHI).

· Candidate MUST have a reliable home-office environment.

Description:

· The Pharmacy Technician is responsible for evaluating & authorizing approval of prior authorization pharmacy requests from prescribers received by telephone and/or fax using client criteria. Primary duties may include, but not limited to:

· Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists.

· Research, resolves, and documents prior authorization outcomes in pharmacy system.

· Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists.

· Escalates requests to Pharmacist when request requires extensive clinical review or denial.

· Research, resolves, and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.

· Verifies member information and inputs data for the pharmacists.

· Educates members on pharmacy-based rules related to prescriptions and medication resources or assistance programs.

· Processes prior authorization requests from physicians’ offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations.

· Provides resolution to grievances and appeals issues.

· Maintains record keeping of prior authorizations, rebates, and monthly reports.

Qualifications:

· Requires High School diploma or GED, and 2 years of pharmacy experience.

· Certified Pharmacy Technician (CPhT) or Pharmacy Technician Certification Board (PTCB).

· In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).

· Proficiency in Pharmacy computerized systems and software applications, as well as Windows-based applications and MS Office Product Suite.

· Ability to follow clinical criteria and instructions to approve prior authorization requests.

Preferred Qualifications:

· Prior call center experience strongly preferred.

· Medical terminology training, pharmaceutical terminology experience and/or experience in medical, insurance or pharmaceutical field are preferred.

· Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.

· Ability to respond to escalated concerns in a calm and professional manner in attempts to prevent further escalations.

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I'd love to talk to you if you think this position is right up your alley, and assure a prompt communication, whichever direction. If you're looking for rewarding employment and a company that puts its employees first, we'd like to work with you.

Satwinder “Sat” Singh

Lead Technical Recruiter

Company Overview:

Amerit Consulting is an extremely fast-growing staffing and consulting firm. Amerit Consulting was founded in 2002 to provide consulting, temporary staffing, direct hire, and payrolling services to Fortune 500 companies nationally; as well as small to mid-sized organizations on a local & regional level. Currently, Amerit has over 2,000 employees in 47 states. We develop and implement solutions that help our clients operate more efficiently, deliver greater customer satisfaction, and see a positive impact on their bottom line. We create value by bringing together the right people to achieve results. Our clients and employees say they choose to work with Amerit because of how we work with them - with service that exceeds their expectations and a personal commitment to their success. Our deep expertise in human capital management has fueled our expansion into direct hire placements, temporary staffing, contract placements, and additional staffing and consulting services that propel our clients’ businesses forward.

Amerit Consulting provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Applicants, with criminal histories, are considered in a manner that is consistent with local, state and federal laws.

Job Types: Full-time, Contract

Salary: $18.00 - $22.00 per hour

Benefits:

• Health insurance

Schedule:

• 8 hour shift

Education:

• High school or equivalent (Required)

Experience:

• Pharmacy Technician: 2 years (Required)
• Microsoft Office: 2 years (Required)

License/Certification:

• CPhT or PTCB (Required)

Work Location: Remote

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