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Location

Redlands, CA | United States

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Job description

Description:

Responsibilities:

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.

information being provided to internal and external customers. Communication with other internal groups regarding determination status and results (seniors, pharmacists, appeals, etc). Identify and elevate clinical inquiries to the pharmacist team as appropriate.

Experience


0-3 years in a customer service or call center environment managing 75 calls/day.

Preferred :


1-year healthcare industry related experience (hospital, managed care, physician office, PBM etc). Proficient in Windows applications (Word and Excel). Problem solving skills, analytical ability. Strong written communication and interpersonal skills. Minimum 25-30 WPM. Detail oriented with excellent organizational skills. Preferred knowledge of prescription drug products, dosage forms and usage. Medical / pharmacy terminology background.

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Job tags

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Salary