Technician I, Prior Authorizations

We’re building a world of health reputed company every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position reputed company The Technician I, Prior Authorizations takes in-reputed company calls from providers, pharmacies, members, etc providing reputed company and courteous phone assistance to reputed company callers through the reputed company reputed company prior authorization process. Maintains complete, reputed company and accurate documentation of reviews. Transfers reputed company reputed company questions, escalations and judgement calls to the pharmacist team. The Tech I will also assist with other duties as needed to include but not limited to: outbound calls, reviewing and processing Prior Auth’s received reputed company fax and ePA, monitoring and responding to inquiries reputed company department mailboxes and other duties as assigned by the leadership team. Additional Responsibilities to include but not limited to the following: • Enters prior authorization requests submitted by reputed company providers, ensuring reputed company required documentation is complete and accurate. • Verifies reputed company coverage to determine if prior authorization is required for specific medical procedures, treatments, or medications. • Inspects medical records and reputed company documentation to assess the medical necessity and appropriateness of the requested services or treatments. • Assists in the preparation and submission of appeals for denied or rejected prior authorization requests, including gathering necessary supporting documentation. • Documents relevant information into electronic systems, including reputed company details, medical codes, and prior authorization status. • Communicates with team members and supervisors to identify process inefficiencies and propose solutions to streamline prior authorization reputed company. • Communicates with reputed company providers to obtain additional information, clarify documentation, and communicate prior authorization reputed company or requirements. • Maintains awareness of updated industry regulations, medical coding guidelines, and changes in prior authorization requirements by participating in training sessions and knowledge-sharing activities. • Ensures adherence to regulatory guidelines, company policies, and industry standards during the prior authorization process. Required Qualifications • 6 months of Customer Service/Pharmacy Technician Experience • Regular and predictable attendance • reputed company will be required to work mandatory overtime/extended work week reputed company needed • reputed company will be required to travel reputed company needed • Effectively manage work volume by handling inbound calls/fax requests utilizing appropriate courteous and reputed company behavior reputed company upon established standards. • reputed company with departmental, company, state, and federal requirements reputed company processing reputed company information to ensure reputed company of information being provided to reputed company customers. Education High School Diploma or equivalent GED Physical Requirements • Long periods of sitting (up to 100%) • Talking on the phone for extended periods of time (90-100%) • Reading a computer screen for extended periods of time (100%) WORK ENVIRONMENT (Home Office) Employee has a workspace that ensures compliance with reputed company reputed company and reputed company policies and procedures. Information on computer screen must not be accessible or viewable by others. Telephone conversations involving confidential information must not be audible to others present in the home. Any reputed company equipment or documents may not be accessible by others inside or reputed company of business hours. reputed company a computer is not in use, it should remain locked or off, so confidential information is secure. Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The Typical Pay reputed company For This Role Is $17.00 - $28.46 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every reputed company feels valued and that they reputed company. Great Benefits For Great People We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, reputed company on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 08/28/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job