Senior Pharmacy Prior Authorization & Appeals Technician - Remote Opportunity

Join Our Team and Make a Difference in Healthcare! We're seeking a highly skilled and dedicated Senior Pharmacy Prior Authorization & Appeals Technician to join our team in a remote capacity. As a key member of our team, you will play a vital role in delivering exceptional customer service and ensuring seamless prior authorization processes for our members and healthcare providers. This is a fantastic opportunity to work with a global organization that is committed to improving health outcomes and advancing health equity on a global scale.

At Optum, you will be part of a culture that values diversity, inclusion, and career development. We offer a competitive salary package, comprehensive benefits, and a dynamic work environment that supports your growth and well-being. If you're passionate about making a positive impact in the lives of others, we encourage you to apply for this exciting role.

About the Position

As a Senior Pharmacy Prior Authorization & Appeals Technician, you will be responsible for providing expert support to members, customers, and healthcare providers. Your primary duties will include:

• Answering prior authorization inbound calls from providers and members (up to 50-70 calls per day)
• Researching and resolving formulary and benefit issues using relevant reference materials
• Processing authorizations through various computer systems and ensuring data accuracy
• Documenting interactions with callers in accordance with contractual and regulatory requirements
• Resolving issues and complaints in a timely and professional manner
• Gathering member data to support pharmacist consultations

Requirements

To be successful in this role, you will need:

• An active and unrestricted licensure/certification as a Pharmacy Technician (PTCB, State Board of Pharmacy Licensure, ExCPT, or NBPA)
• At least 6 months of customer service experience in a healthcare setting
• Basic proficiency in Microsoft Excel, Word, and Outlook
• Ability to work flexible hours, including overtime and weekends, between 5:00 AM and 12:00 AM

Nice-to-Haves

While not required, the following skills and experience are desirable:

• Knowledge of call center systems, such as IEX
• Strong communication skills, both written and oral
• Ability to follow through on tasks and prioritize responsibilities

Benefits

We offer a comprehensive benefits package, including:

• Paid Time Off and 8 Paid Holidays + Floating Holiday
• Medical, Dental, Vision, Life, and AD&D Insurance
• 401(k) Savings Plan and Employee Stock Purchase Plan
• Education Reimbursement and Employee Discounts
• Flexible Work Arrangements and Voluntary Benefits

Your Future Starts Here

Don't miss out on this exciting opportunity to join our team and make a difference in healthcare. Apply now to take the first step towards a rewarding and challenging career as a Senior Pharmacy Prior Authorization & Appeals Technician.

Apply To This Job