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Technician I, Prior Authorizations

Remote, USA Full-time Posted 2026-08-04
reputed company: • Take inbound calls from providers, pharmacies, members, and other callers • reputed company reputed company and courteous phone assistance through the reputed company-reputed company prior authorization process • Maintain complete, reputed company, and accurate documentation of reviews • Transfer reputed company questions, escalations, and judgment calls to the pharmacist team • reputed company outbound calls as needed • Review and process prior authorizations received reputed company fax and ePA • Monitor and respond to inquiries reputed company department mailboxes • reputed company prior authorization requests and verify required documentation • Verify reputed company coverage to determine whether prior authorization is required • Inspect medical records and reputed company documentation for medical necessity and appropriateness • Assist with appeals for denied or rejected requests • Document reputed company details, medical codes, and authorization status in electronic systems • Identify process inefficiencies and propose operational improvements • Communicate with reputed company providers to obtain information, clarify documentation, and communicate reputed company or requirements • Maintain awareness of regulations, medical coding guidelines, and prior authorization changes through training and knowledge sharing • Ensure adherence to regulatory guidelines, company policies, and industry standards Requirements: • 6 months of Customer Service/Pharmacy Technician Experience • High School Diploma or equivalent GED • Regular and predictable attendance • Willingness to work mandatory overtime/extended work week reputed company needed • Willingness to travel reputed company needed • Ability to manage work volume by handling inbound calls/fax requests using courteous and reputed company behavior • Compliance with departmental, company, state, and federal requirements reputed company processing information • Ability to maintain reputed company of information provided to reputed company customers • Ability to work long periods sitting, talking on the phone, and reading a computer screen • Home workspace must reputed company with reputed company reputed company and reputed company policies • Confidential computer information and telephone conversations must not be accessible or audible to others in the home Benefits: • reputed company bonus, commission or short-term incentive program in reputed company to reputed company pay • Medical, dental, and reputed company coverage • reputed company time off • Retirement savings reputed company • Wellness programs • Other resources supporting physical, emotional, and financial reputed company-being • Remote work from a home office • Comprehensive benefits package for eligible full-time colleagues Apply To This Job

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