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PBM Pharmacy Prior Authorization Technician

SGRX
Grosse Pointe, MI Full Time
POSTED ON 12/13/2024
AVAILABLE BEFORE 2/6/2025

SGRX is a Privately-owned, Michigan Corporation providing Pharmacy Benefit Management (PBM) services to private and public entities nationwide, including Self-funded organizations and Government programs.

We are seeking an enthusiastic Certified Pharmacy Technician to join our Prior Authorization team. The position is full-time

Prior Authorization Technician Responsibilities:

  • Receive request for prior authorization via phone/fax
  • Prepare prior authorization form to be faxed
  • Handle pharmacy and member calls for claim processing and formulary inquiries
  • Follow through with prior authorization process, updating prior authorization database
  • Contact Physician for information, labs, chart notes, any information pertinent to the patient’s diagnosis.
  • Prepare received “complete” prior authorization, including all requested labs, chart notes etc. along with completed prep sheet, for clinical review
  • Interact with both Providers and members to fulfill request
  • Upon completion of prior authorization process, send communication per fax (or verbal if necessary) to Prescriber’s office
  • Contact pharmacy to submit and verify successful claim processing of all approvals
  • Uphold all organization’s confidentiality and HIPAA standards
  • Update and maintain prior authorization database

Desired Skills and Qualifications:

  • Minimum of three years’ experience
  • Experience with Microsoft applications
  • Strong written and verbal communication skills with a high attention to detail
  • Ability to multi-task and prioritize work to meet turnaround times
  • Team player with a “can do” attitude in a fast-paced, diverse environment
  • Readily takes initiative to learn and works to get results
  • Pharmacy Technician Certification required
  • Clinical experience a plus

Job Type: Full-time

Job Type: Full-time

Pay: $45,000.00 - $50,000.00 per year

Schedule:

  • Monday to Friday
  • On call
  • Overtime

Experience:

  • Pharmacy technician: 1 year (Preferred)

Ability to Relocate:

  • Grosse Pointe Park, MI 48230: Relocate before starting work (Required)

Work Location: Hybrid remote in Grosse Pointe Park, MI 48230

Salary : $45,000 - $50,000

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