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UnitedHealth Group - South Portland, ME
posted 3 months ago
About the position
The Senior Pharmacy PA/Appeals Technician role at UnitedHealth Group involves providing expertise and customer service support for prior authorization requests related to medications. This remote position requires handling inbound calls, processing authorizations, and ensuring compliance with legal and contractual requirements. The technician will work in a fast-paced environment, focusing on patient safety and quality of work while contributing to health equity and improving health outcomes.
Responsibilities
- Answer inbound calls for prior authorization requests from providers and members, handling up to 70 calls per day.
- Process authorizations through various computer systems, ensuring data accuracy and compliance with guidelines.
- Review and process prior authorization requests for medications not covered on a member's prescription drug plan.
- Document interactions with callers according to regulatory and contractual requirements.
- Resolve issues and complaints in a timely manner.
- Gather member data for pharmacist consultations as needed.
- Perform other duties as assigned by management.
Requirements
- Active National Pharmacy Technician Certification from PTCB, ExCPT, or National Board of Prior Authorization Specialist.
- 6+ months of customer service experience with healthcare professionals.
- Basic proficiency in Microsoft Excel, Word, and Outlook.
- Ability to work flexible hours, including early mornings, late nights, and weekends.
- Must reside in the state of Maine.
Nice-to-haves
- Knowledge of call center systems such as IEX.
Benefits
- Paid Time Off (PTO) and 8 Paid Holidays + Floating Holiday
- Medical Plan options with Health Spending Account or Health Saving Account
- Dental, Vision, Life & AD&D Insurance, Short-term and Long-term Disability coverage
- 401(k) Savings Plan and Employee Stock Purchase Plan
- Education Reimbursement
- Employee Discounts
- Employee Assistance Program
- Employee Referral Bonus Program
- Flexible Work Arrangement
- Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
