Tekwissen
Pharmacy Technician
Tekwissen, Detroit, MI, United States
Overview:
TekWissen Group is a workforce management provider throughout the USA and many other countries in the world. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family, dental and vision, plans for employers, etc.
Title: Pharmacy Technician
Work Location: Detroit, MI, 48243
Duration: 6 Months
Job Type: Contract
Work Type: Remote
Job Description:
SUMMARY
TekWissen® Group is an equal opportunity employer supporting workforce diversity.
TekWissen Group is a workforce management provider throughout the USA and many other countries in the world. Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family, dental and vision, plans for employers, etc.
Title: Pharmacy Technician
Work Location: Detroit, MI, 48243
Duration: 6 Months
Job Type: Contract
Work Type: Remote
Job Description:
SUMMARY
- Support the client providers (pharmacists and physicians) with Medicare Part D and/or Commercial pharmacy/specialty drug benefits analysis, drug coverage inquiries and prior authorizations.
- Answer telephones in an efficient and timely manner to lend appropriate assistance to providers
- Triage prior authorization requests under the supervision of a Clinical Pharmacist.
- Assists in maintaining pharmacy prior authorization criteria used in the adjudication of pharmacy/specialty
claims. - Analysing written inquiries which lends to entry and updating of pharmacy authorizations into the claims
system. - Communicate coverage determination status to physicians and/or members and effectuate such decisions
within the authorization tool. - Troubleshoot problems, inquiries, and new processing procedures for coverage determinations.
- Assist with internal control systems and regulations compliance.
- Perform other related duties as assigned.
- High School Graduate of GED equivalent required. Two (2) years of college preferred.
- Two (2) years experience in retail or hospital Pharmacy required.
- Pharmacy Technician Certification (PTCB) preferred
- Knowledge of prescription drug names, therapeutic classes and claims processing
- Experience with Medicare Part D prescription benefits may be preferred for some positions
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
- The requirements listed below are representative of the knowledge, skill, and/or ability required.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Expert knowledge of pharmacy claims processing
- Understanding of formularies and utilization management edits
- Familiarity with pharmaceutical manufacturers and product/cost information
- Computer Literate (Microsoft Office Products).
TekWissen® Group is an equal opportunity employer supporting workforce diversity.