Optech Detroit , MI 48222
Posted 1 week ago
Job Title: Pharmacy Technician
Why work at OpTech?
OpTech is a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work at OpTech, not only do you get health and dental benefits on the first day of employment, but you also have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. Apply today! To view our complete list of openings, please visit our website at www.optechus.com.
SUMMARY:
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned:
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
Analyzing 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
QUALIFICATIONS:
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.
OTHER SKILLS AND ABILITIES:
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).
EDUCATION AND/OR EXPERIENCE:
High School Graduate of GED equivalent required. Two (2) years of college preferred.
Two (2) years of 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
OpTech is an equal opportunity employer and is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, status as a parent, disability, age, veteran status, or other characteristics as defined by federal, state or local laws. https://www.optechus.com/eeo_self_identification/
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