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Clinical Pharmacy Technician I | Prior Authorization | Remote | *CPhT is Required

Ventegra
Remote

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Job Details

Full-time
$20 an hour

Qualifications

Customer communication
Microsoft Excel
Microsoft Outlook
Interpersonal skills
Pharmacy Technician License
Pharmacy technician experience
High school diploma or GED
Pre-authorization review for utilization management
Attention to detail
Adaptability

Full Job Description

Job Purpose

Ventegra is a rapidly growing, fast paced, innovative virtual company. As part of Ventegra, the Pharmacy Technician I, provide daily operational support to the Pharmacist and Customer Care Specialist related to prior authorizations. The Pharmacy Technician 1 has the clinical skills to review and evaluate the appropriateness and medical necessity of medications based on established criteria. The Pharmacy Technician I, promotes and supports quality pharmacy services.

Duties and Responsibilities

Maintain an accurate and current knowledge of required criteria, training materials, systems, prior authorization processes and plan benefits
Accurately enter authorizations approvals in the claims processing system
Accurately document case notes relate to member’s medications as required in the prior authorization review process
Review incoming fax requests for medications requiring a prior authorization, while ensuring an elevated level of customer service and maximizing productivity. Requests additional information from providers as needed to properly evaluate the request
Assist Clinical Pharmacist by providing accurate documentation and clear clinical notes related to a prior authorization request
Provide clinical review and determinations of prior authorization in keeping with legal and contractual requirements, including turnaround times and service level agreements
Escalate issues through the appropriate channel of management to ensure patient has access to medications
Effectively manages and prioritize prior authorization requests based on turn-around times
Effectively communicates both internally and externally to enhance the effectiveness of pharmacy prior authorization process and ensure the needs of the members and clients are met
Must maintain the highest level of member confidentiality and adheres to all company policies regarding confidentiality and HIPAA
Assist in the processing of telephonic prior authorizations request from physicians using established criteria and guideline
Assist with other duties and responsible as assign by management based on department needs

Required Skills and Abilities

Excellent verbal and written communication skills
Ability to focus and prioritize
Accurate and detail oriented
Ability to multi-task with minimal direction
Flexibility and ability to adapt to changes and updates to processes and protocols
Demonstrate problem-solving skills, information gathering, research, alternatives analysis, applying creative solutions to unique and/or immediate issues
High volume call center experience a plus
Experience processing in pharmacy prior authorization request using medication criteria
Proficient in Microsoft Office programs (Word, Excel, Outlook, etc.)
Dependability and good attendance are an essential function of the job

Education and Experience

High School Diploma or GED equivalent.
Current Pharmacy Technician License required; Certified Pharmacy Technician License (CPhT) required
1-year experience as a Pharmacy Prior Authorization Technician or minimum 1-year experience as a Ventegra Customer Care Specialist (CCS) with Technician Certification (CPhT required)
1-year experience as a Pharmacy Benefit Management(PBM) Prior Authorization Technician preferred

Work environment requirements

A home office setting, free from noise and distraction allowing you to interact professionally both externally and internally.

Pay: $20.00 per hour

Application Question(s):

Do you have a valid PTCB or NHA pharmacy technican certification?
Do you have Pharmacy Benefit Management(PBM) experience? If yes, how many years?
Are you authorized to work in the United States?
Are you available to work any time from 7:00am PST to 8:00pm MST?
Are you available a 4-6 weeks Training Schedule 7:00am PST to 3:30pm MST?

Work Location: Remote

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