<p>Job Title: Pharmacy Technician</p> <p>Why work at OpTech?</p> <p>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, pleas e visit our website at www.optechus.com.</p> <p>RESPONSIBILITIES:</p> <p>Engagement Description:</p> <ul> <li>Prior authorization specialists assist with the intake of prior authorization requests, prepare cases for clinical review, and answer phone calls and inquiries from providers and pharmacies </li><li>Support Our Client's providers (pharmacists and physicians) with Medicare Part D and/or Commercial pharmacy/ specialty drug benefits analysis, drug coverage inquiries and prior authorizations. </li></ul> <p>ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned:</p> <ul> <li>Answer telephones in an efficient and timely manner to lend appropriate assistance to providers </li><li>Triage prior authorization requests under the supervision of a Clinical Pharmacist </li><li>Assists in maintaining pharmacy prior authorization criteria used in the adjudication of pharmacy/specialty claims </li><li>Analyzing written inquiries which lends to entry and updating of pharmacy authorizations into the claims system </li><li>Communicate coverage determination status to physicians and/or members and effectuate such decisions within the authorization tool </li><li>Troubleshoot problems, inquiries, and new processing procedures for coverage determinations </li><li>Assist with internal control systems and regulations compliance </li><li>Perform other related duties as assigned </li></ul> <p>QUALIFICATIONS:</p> <ul> <li>To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. </li><li>The requirements listed below are representative of the knowledge, skill, and/or ability required. </li><li>Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. </li></ul> <p>Top 3 Required Skills/Experience:</p> <ul> <li>2 years of retail pharmacy experience </li><li>Computer and Microsoft office experience </li><li>Customer Service </li></ul> <p>Required Skills/Experience:</p> <ul> <li>Basic Pharmacy and medical terminology </li><li>Pharmacy claim adjudication experience </li><li>Knowledge of basic drug classes </li></ul> <p>Preferred Skills/Experience:</p> <ul> <li>Certified Pharmacy Technician </li></ul> <p>OTHER SKILLS AND ABILITIES:</p> <ul> <li>Expert knowledge of pharmacy claims processing </li><li>Understanding of formularies and utilization management edits </li><li>Familiarity with pharmaceutical manufacturers and product/cost information </li><li>Computer Literate </li></ul> <p>EDUCATION AND/OR EXPERIENCE:</p> <ul> <li>High School Graduate of GED equivalent required </li><li>Two (2) years of college preferred </li><li>Two (2) years of experience in retail or hospital Pharmacy required </li><li>Pharmacy Technician Certification (PTCB) preferred </li><li>Knowledge of prescription drug names, therapeutic classes and claims processing </li><li>Experience with Medicare Part D prescription benefits may be preferred for some positions </li></ul> <p>Additional Information:</p> <ul> <li>The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. </li><li>They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. </li><li>This job description does not constitute a contract for employment. </li></ul> <p>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/</p>