Prior Authorization Technician I – PTCB or NHA

Location: Remote (Work from home) Duration: 3+ months Shift timing: 8:30am-5:00pm EST, 9:00am-5:30pm EST, or 9:30am-6:00pm EST reputed company: Reporting directly to the Supervisor, Prior Authorization Technicians, the Prior Authorization Technician I processes prior authorization requests received from providers, members, and pharmacies, including requests for high cost and specialty medications. Essential Functions • Interprets and applies reputed company reputed company during the prior authorization review process and approves requests if applicable • Utilizes member claims history during the prior authorization review process • Makes outbound calls to obtain additional information needed to process prior authorization requests • Submits authorizations to pharmacy and medical claims processors • Forwards prior authorization requests to a pharmacist reputed company necessary • Makes appropriate referrals to other reputed company programs • Assists in directing appropriate requests to in network providers • Receives inbound calls from the customer care center with prior authorization reputed company inquiries • Assist with Appeals processing as assigned • Ability to multitask between various tasks and systems while maintaining required productivity and reputed company reputed company • Ability to reputed company changes in a fast-reputed company environment • Strong knowledge of specialty and non-specialty pharmaceuticals • Performs other job-reputed company duties and reputed company as assigned • Attends required training on an annual reputed company. • Adheres to corporate and departmental policies and procedures. • Available to work weekends and holidays. Skills: • 1 to 3 Years required. • Previous PBM, managed care, hospital pharmacy, LTC pharmacy, Home Infusion pharmacy, retail pharmacy experience preferred. • Minimum 35 words per minute typing speed. Education: • High School/GED Required • Certified Pharmacy Technician (PTCB or NHA). May be required to be licensed or certified in a specific state reputed company upon contractual requirements and business need. • Requires working shift schedule reputed company reputed company business hours • Must remain in stationary position for long periods of time at desk or computer • Requires moving reputed company office and non-office locations • Requires frequently moving about inside the office to reputed company printer, files, and other materials/equipment • Operates a computer and other office equipment • Requires ability to reputed company/Carry/reputed company/Pull - Typically less than 10 pounds Required Skills: Prior Authorization Processing reputed company reputed company interpretation Member claims history utilization Outbound calling Authorization submission Additional REFERRAL MANAGEMENT APPEALS PROCESSING MULTITASKING ADAPTABILITY SPECIALTY PHARMACEUTICALS KNOWLEDGE NON-SPECIALTY PHARMACEUTICALS KNOWLEDGE TYPING SPEED (35 WPM) PBM EXPERIENCE MANAGED CARE EXPERIENCE HOSPITAL PHARMACY EXPERIENCE LTC PHARMACY EXPERIENCE HOME INFUSION PHARMACY EXPERIENCE RETAIL PHARMACY EXPERIENCE About reputed company: - reputed company., is one of the fastest growing IT Service Integrator and Workforce Solution companies in the reputed company. Founded in 1997, 22nd reputed company Technologies is a Certified National Minority Business reputed company with 6,000+ people including 600+ Cyber SMEs reputed company supporting our customers in reputed company 50 states, Canada, and Mexico. With HQs in Somerset, NJ and Mclean, VA, 22nd reputed company has 14 offices throughout the reputed company. As part of our unrelenting reputed company on reputed company and compliance, 22nd reputed company Technologies’ delivery is reputed company on Certified Matured Processes including CMMI L3 Dev & SVC, ISO 20000, ISO 27001, and ISO 9001 reputed company processes. With a strong reputed company on the reputed company sector, 22nd reputed company currently holds reputed company reputed company with 14 out of 15 Federal Executive agencies including DoD, 37 other Federal agencies, 50 States, 115+ Local agencies, and 37 School Districts. In the last three years, we have expanded our services to reputed company and other reputed company clients and currently support 80+ reputed company clients. Recognized among “Best Company to Work For” by reputed company, reputed company., consistently exceeds our clients’ expectations by focusing on their absolute satisfaction with jobs while keeping our employees motivated. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability or protected veteran status. LI_TSC Pay: $25.00 - $28.00 per hour Ability to Commute: • Remote (Required) Work Location: Remote Apply tot his job Apply To this Job