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Certified Pharmacy TechnicianNashville, TNResponsible for assisting members, physicians and pharmacies in claims processing. Includes Pharmacy Appeals and Prior Authorization. For the Pharmacy Appeals Unit, may be responsible for handling member and provider calls about denied authorizations and are responsible for reporting performance against CMS guidelines. Required Skills Responsible for assisting members, physicians and pharmacists with second level (clinical) pharmacy related issues. Primary focus is on responding to inquiries specifically related to medications (i.e.: process and/or approve requests for Prior Authorization or member reimbursements, assist pharmacies on adjudicating claims over the phone, answer formulary questions regarding therapeutic alternatives, etc.) Troubleshooting benefit and prescription questions... See job listing >25 days ago from Pharmacy Times - Save - Block - Flag - More Tools...
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