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Prior Authorization Pharmacy Technician

2 hours, 51 minutes ago
United States
Full-time
Junior
Customer Support
Customer and Technical Support
Apply Now
Oscar

Oscar

Oscar is a health insurance company that offers plans for individuals, families, and small businesses. With a focus on humanizing health care through technology, design, and data, Oscar provides easy-to-understand bills, 24/7 access to doctors, and a p...

Insurance
1K-5K
Founded 2012
View All Jobs 125

Description

  • Use Oscar and vendor tools to verify eligibility, screen required documents, create requests, and track pharmacy prior authorization cases.
  • Prepare, organize, and route prior authorization requests for pharmacist or physician review.
  • Collect relevant medical information by phone, fax, and portal and apply the appropriate prior authorization criteria.
  • Document communications and decision-making clearly and accurately.
  • Meet decision-making timeframes and escalate cases requiring pharmacist review promptly.
  • Communicate prior authorization decisions through oral and written notifications that meet content and accuracy standards.
  • Follow all applicable laws and regulations.
  • Support escalated prior authorization issues and complete other duties as assigned.

Requirements

  • 2+ years of work experience in a pharmacy-related field in a retail or managed care plan setting and/or prior authorization experience.
  • Active, unrestricted Pharmacy Technician certification (CPhT).
  • Excellent customer service, phone etiquette, and typing skills.
  • 1+ years of experience performing pharmacy reviews for a managed care plan or pharmacy benefits manager (preferred).
  • Experience working with CVS Caremark's portal and criteria (preferred).
  • In-depth understanding of how to operationalize step therapy rules and regulations (preferred).
  • Strong verbal and written communication skills and interpersonal skills (preferred).

Benefits

  • Base pay of $19.11 - $25.08 per hour in CA, CT, NJ, NY, and WA, or $17.20 - $22.57 per hour in all other locations.
  • Eligible for employee benefits.
  • Monthly vacation accrual at a rate of 15 days per year.
  • Medical, dental, and vision benefits.
  • 11 paid holidays.
  • Paid sick time.
  • Paid parental leave.
  • 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Interested in this position?

Apply directly on the company website

Apply Now

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