What are the responsibilities and job description for the Pharmacy Technician position at Talent World Group?
About Us :
Think Global - Expect Amazing! TalentWorldGroup is a Revolutionary Multilingual Contact Center. We are a truly peoples company and we are on a mission to reinvent professional Home-Based Working and build the Workplace of the Future!
Position Overview :
We are seeking thirty Remote Pharmacy Technicians based in the US (Licensed in Illinois), to work for a premium client in the medical field. This is a fully remote / work-from-home position providing support to customers.
Key Responsibilities :
- Reviews pertinent patient information and checks appropriateness using clinical criteria. Makes approval recommendations on all services that meet clinical review criteria. Refers all cases not meeting clinical criteria to pharmacist clinical reviewer.
- Practices and maintains the principles of utilization management by adhering to the company policies and procedures. Upholds clinical integrity of pharmaceutical solutions by participating in ongoing training programs to ensure quality performance in compliance with applicable standards and regulations. Expert within the organization.
- Assists with the documentation and implementation of both written and verbal communications to physicians / prescribers and assists in the maintenance of the edits and data elements that support the edits.
- Available for consultation in pharmacy related questions to resolve claims submission related to medication edits.
- Contacts physicians / prescribers to obtain pertinent clinical history / information. Provides optimum customer service through professional / accurate communication while maintaining NCQA and health plan`s required timeframes.
- Regularly reviews and monitors information on pended claims identified as outliers by internal and / or external analysis of pharmacy claims data.
- Supports Intake call volume and order entry if necessary.
- Determines eligibility for medication reimbursement based upon established clinical criteria and clinical knowledge and enters approvals or denials in the system.
- Electronically documents both written and verbal communications with physicians, their staff, cardholders, and pharmacies.
- Escalates medical exception requests to nurse, pharmacist or physician on the utilization review clinical team when further review is necessary.
- Other duties as assigned.
Training Program :
Why Join Us?
Requirements
Internet :
Hardware Requirements :
Operating System
Benefits
Additional information :
Salary : 20
Frequency : Per hour
Employment type : Full-time
Salary : $20
