Job Type: Long Term Contract
Position Summary
- Responsible for processing pharmacy prior authorization requests in accordance with established policies, procedures, and clinical protocols.
- Supports providers, pharmacies, and internal staff by resolving pharmacy benefit inquiries, processing authorizations, and maintaining accurate documentation.
- Provides administrative support to the pharmacy team while ensuring timely communication and quality service.
Key Responsibilities
- Process pharmacy prior authorization requests.
- Review and issue prior authorizations according to established protocols and policies.
- Communicate authorization approvals and denials to physicians and pharmacies by phone and/or written correspondence.
- Respond to questions from providers, pharmacists, physicians, and internal staff regarding pharmacy benefit issues.
- Resolve routine pharmacy-related provider concerns and determine appropriate actions.
- Assist with prescription benefit, formulary, claim processing, and prior authorization inquiries.
- Document all communications and actions in the telephone call tracking system.
- Maintain accurate records of authorization decisions and customer interactions.
- Provide administrative support to the pharmacy team.
- Prepare and distribute policies, procedures, committee agendas, meeting minutes, and other correspondence.
- Collaborate with internal teams to ensure timely resolution of pharmacy-related issues.
- Follow organizational policies, procedures, and regulatory requirements.
Required Qualifications
- Associate's Degree in a health-related field or Pharmacy Technician certification required.
- Experience working for a Pharmacy Benefit Management (PBM) company or a managed care health plan.
- Knowledge of retail pharmacy third-party prescription processing.
- Knowledge of pharmacy utilization management programs, including prior authorization, quantity limits, step therapy, and generic programs.
- Strong understanding of drug categories, brand and generic medications, including spelling and pronunciation.
- Ability to communicate professionally with physicians, physician offices, pharmacies, and healthcare professionals.
- Basic computer proficiency, including Microsoft Office applications.
Required Skills
- Pharmacy prior authorization processing.
- Pharmacy benefit management (PBM).
- Prescription claim processing.
- Formulary and benefit verification.
- Utilization management.
- Provider and pharmacy communication.
- Medical documentation.
- Customer service and problem-solving.
- Attention to detail and organizational skills.
- Microsoft Office proficiency.
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About our Company: -
22nd Century Technologies Inc., (TSCTI) is one the fastest growing healthcare staffing companies in the United States. With presence in all 50 States and 6000+ employees nationwide, we have been providing unparallel healthcare and technology staffing services to Public and Private sectors for over 26 years.
Started as a technology staffing company in 1997, we have significantly expanded our healthcare practice to both Clinical and Non-Clinical staffing, serving various facilities, healthcare organizations and government agencies. Our ISO certified staffing practices and technology driven staffing procedures – from recruitment to onboarding, along with an internal pre-vetted resume database of healthcare professionals, enable us to serve our customers with their immediate staffing needs.
TSCTI has extensive experience providing Physicians, Nurses, Pharmacists and other Allied Health professionals to various states – California, Connecticut, District of Columbia, Florida, Michigan, Minnesota, New Jersey, New York, Texas, Vermont, Virginia to name a few, and Our valued relationships with employees as well as commitment to meet and exceed clients’ expectations through our exemplary employees proves our competency in today’s healthcare staffing industry.
Recognized among “Best Company to Work For” by Forbes, 22nd Century Technologies, Inc., consistently exceeds our clients’ expectations by focusing on their absolute satisfaction with jobs while keeping our employees motivated.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
Pay: $25.00 - $28.00 per hour
Experience:
- pharmacy prior authorization: 2 years (Required)
- PBM or managed care: 2 years (Required)
- pharmacy claims processing: 2 years (Required)
Ability to Commute:
- Harrisburg, PA 17120 (Required)
Work Location: In person
