Role overview

Qualifications

0-3 years work experience in customer service position
High School diploma or GED required
Active pharmacy technician license or active national certification
Trainee license in states where applicable preferred

Responsibilities

Handle inbound calls/fax/ePA requests professionally and courteously
Comply with requirements to ensure accuracy of information
Communicate with internal groups regarding determination status
Identify and elevate clinical inquiries to the pharmacist team

Key facts

Remote from: Rhode Island (USA)
Fixed term
Mid-level (2-5 years)
Pharmacist
English

Hard skills

Call Center Experience Prior Authorization Internal Documentation

Other skills

Customer Service
Communication
Professionalism

About the company

US Tech Solutions

Staffing & Recruiting

USTECH SOLUTIONS is the largest privately owned diversity workforce partner with a global footprint. For 20+ years, we have partnered with leading MSPs and some of the world’s largest enterprises to deliver a flexible workforce. We serve Fortune 500 giants and growing businesses alike, reinventing the role of humans in a digital workforce. ‘Reinventing Human’ is about connecting you with top talent and seamlessly integrating new hires into your programs through our next gen AI powered Talent platforms. As the largest private diversity supplier in the US, we champion inclusion and unlock hidden potential. We work with leading MSPs and are a trusted strategic partner to the world’s top brands. At USTECH SOLUTIONS, we're inverting the talent hiring pyramid by offering a range of solutions from curated talent pools, workforce management services, and IT services resourcing to IC compliance. Our legacy and close affinity to the computing industry has equipped us with the expertise and vision to provision AI platform solutions that help organizations to innovate faster. Considering Statement of Work? Meet US Tech Digital (ustechdigital.com). We're helping businesses achieve digital leadership through our tailored SOW solutions, utilizing market-leading technology products and our proprietary in-house developed platform solutions. Explore our full range of services and solutions by visiting our website: ustechsolutions.com

Company details

Company typeLarge

IndustryStaffing & Recruiting

Company size1001 - 5000

Links

Website LinkedIn See all jobs

Your match analysis

See how your profile stacks up against this role.

We compared the job requirements to your profile to show where you're strong and where you fall short.

Job description

Job Summary:

The Tech I Prior Auth. takes in-bound calls from providers, pharmacies, members, etc providing professional and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical 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 via fax and ePA, monitoring and responding to inquiries via department mailboxes and other duties as assigned by the leadership team.

Responsibilities:

Effectively manage work volume by handling inbound calls/fax/ePA requests utilizing appropriate courteous and professional behavior based upon established standards. 40%
Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers. 40%
Communication with other internal groups regarding determination status and results (seniors, pharmacists, appeals, etc.). 10%
Identify and elevate clinical inquiries to the pharmacist team as appropriate. 5%
Other duties assigned, for example faxes, sorting, email boxes, CAS maintenance, etc. 5%

Experience:
Preferred 0-3 years work experience required in a customer service position with high volume call center experience; preferably in healthcare, social services, or a similar service position.

Education:

Verifiable High School diploma or GED is required. Associate Degree or Bachelor’s Degree: If neither degree held, then equivalent years of work experience is preferred, Other Certificates or Licenses (List): Active pharmacy technician license per state requirements, or active national certification. Trainee license in states where applicable are preferred.

About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com.

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.