Senior Pharm PA/Appeals Technician - Remote in Wyoming

About the position

The Senior Pharmacy Prior Authorization/Appeals Technician at UnitedHealth Group is responsible for providing expertise and customer service support in processing prior authorization requests for medications. This remote position requires handling a high volume of inbound calls, ensuring compliance with legal and contractual requirements, and maintaining a high level of customer service. The role emphasizes patient safety, quality of work, and effective communication with healthcare providers and members.

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 policies and procedures.
• Review and process prior authorization requests for medications not covered on a member's prescription drug plan, adhering to established criteria and guidelines.
• Document interactions with callers in accordance with regulatory and contractual requirements.
• Resolve issues and complaints in a timely manner, providing excellent customer service.
• Perform additional 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 the state of residence.
• ExCPT - Pharmacy Technician Certification with National Healthcareer Association (NHA).
• The National Board of Prior Authorization Specialist certification.
• 6+ months of customer service experience with healthcare professionals.
• Basic proficiency in Microsoft Excel, Word, and Outlook.

Nice-to-haves

• Knowledge of call center systems such as IEX.
• Strong written and oral communication skills to improve Net Promoter Survey (NPS) scores.

Benefits

• Paid Time Off (PTO) starting from the first pay period plus 8 Paid Holidays and a Floating Holiday.
• Medical Plan options with Health Spending Account or Health Saving Account participation.
• 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, etc.).