Hillside, IL 60162
Full-time


Position : Pharmacy Technician – Prior Authorization Department

Industry: Healthcare – Pharmaceutical

Location: Hillside, IL

Company: UnitedRx

  • UnitedRx serves the pharmaceutical needs of long-term care facilities and their patients

Shift/Hours :

  • 9:00 am – 5:30 pm M-F. Occasional Saturday or Sunday

Benefits :

  • UnitedRx offers a competitive benefits package for full time employees which includes medical with prescription drug plan, dental, vision, life, 401k, etc.

Requirements:

  • Knowledge of common medication names, usage and diagnosis
  • Education: High School Diploma
  • Years of experience: 1+ year(s) of recent pharmacy experience within a retail, hospital, or mail order setting
  • Background/drug requirements: Ability to successfully complete background check, and drug screen
  • Framework Experience a plus.

Responsibilities:

As a Prior Authorization Pharmacy Technician you will be responsible for maintaining productivity and quality standards as well as legal and company compliance and track and triage all coverage determination requests for approvals

  • Track and triage coverage determination requests submitted from providers and determine if a pharmacist review is required
  • Obtain verbal authorizations and request detailed clinical information from prescribers
  • Approve coverage determination requests based on defined criteria within the scope of approved protocols or decision trees
  • Enter and document coverage determination request decision into the system and notify providers and/or members
  • Respond to client inquiries regarding authorization approvals and on-line applications
  • Refer coverage determination requests for specialty drugs to delegated vendor or client for processing
  • Contact providers for additional information to facilitate coverage determination reviews
  • Notify physicians, providers and members of coverage determination request decisions
  • Working with ALL Medicare Part D plans, Medicaid and or other insurance plans, working through the different checks and balances

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