Senior Pharm PA/Appeals Technician - Remote in Wyoming

About the position

The Pharmacy Technician in Prior Authorization at Optum plays a crucial role in providing expertise and customer service support to members, customers, and providers. This position is responsible for handling incoming requests for prior authorizations for medications, ensuring compliance with legal and contractual requirements, and maintaining high levels of customer service. The role involves processing authorizations, conducting clinical reviews, and documenting interactions accurately. The position offers the flexibility to telecommute for residents of Wyoming, contributing to health equity on a global scale.

Responsibilities

• Answer prior authorization inbound calls from providers and members (up to 50 to 70 calls per day).
• Research and resolve formulary and benefit issues using appropriate reference material.
• Process authorizations through various computer systems, ensuring data accuracy and updates as necessary.
• Receive and process prior authorization requests made by providers and members for medications not covered on a member's prescription drug plan.
• Ensure patient safety and quality of work, maintaining a safe and secure workspace.
• Resolve issues and complaints in a timely manner.
• Gather member data for pharmacist consultations based on inbound phone requests.
• Perform other duties as assigned by management.

Requirements

• Active National or Wyoming State Board Pharmacy Technician Licensure.
• Pharmacy Technicians Certification Board (PTCB) certification.
• State Board of Pharmacy Licensure in state of residence.
• ExCPT - Pharmacy Technician Certification with National Healthcareer Association (NHA).
• 6+ months of customer service/customer relations experience with healthcare professionals.
• Basic proficiency with Microsoft Excel, Word, and Outlook.
• Ability to work flexible hours, including overtime and weekends, from 5am to 12 midnight.
• Must reside in the state of Wyoming.

Nice-to-haves

• Knowledge of call center systems such as IEX.
• Strong communication skills, both written and oral.

Benefits

• Paid Time Off (PTO) starting from the first pay period plus 8 Paid Holidays and a Floating Holiday.
• Medical Plan options with participation in a 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 and Employee Discounts.
• Employee Assistance Program and Employee Referral Bonus Program.
• Flexible Work Arrangement and Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.).