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Prior Authorization Pharmacy Technician II
Elevance Health. Interpret and enter moderately complex prescriptions .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in processing prior authorizations, interpreting prescriptions, and ensuring compliance with Medicare requirements. Strong communication and problem-solving skills are essential for educating members and resolving inquiries effectively.
Highest-signal resume keywords
Active Professional LicenseState Pharmacy Technician CertificationMinimum 2 Years Pharmacy ExperiencePrior Authorization ProcessingCompliance with Medicare Requirements
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Prescription InterpretationAdjudication TroubleshootingData Entry for PharmacistsRecord MaintenanceFormulary Knowledge
Soft Skills
Strong Oral CommunicationWritten Communication SkillsInterpersonal CommunicationProblem-Solving SkillsFacilitation Skills
Certifications & Qualifications
State Pharmacy Technician CertificationNational Certification
Industry Keywords
Prior AuthorizationMedicare CompliancePharmacy RulesMedication ResourcesGrievances and Appeals
About the role
Key responsibilities & impact- Interpret and enter moderately complex prescriptions
- Process prior authorizations
- Troubleshoot adjudication issues
- Verify member information and input data for pharmacists
- Educate members on pharmacy rules related to prescriptions and medication resources or assistance programs
- Process prior authorization requests from physician offices
- Ensure compliance with Medicare requirements
- Inform relevant parties of prior authorization determinations
- Resolve grievances and appeals issues
- Respond to inquiries from physicians, the sales team, and members regarding formulary and prescription benefits
- Maintain records of prior authorizations, rebates, and monthly reports
Requirements
What you’ll need- Active professional license, if required by state law
- State Pharmacy Technician Certification or National Certification based on applicable state requirements
- Requires a high school diploma or equivalent
- Minimum of 2 years of pharmacy experience
- Any combination of education and experience providing an equivalent background may qualify
- Strong oral, written, and interpersonal communication skills
- Problem-solving skills
- Facilitation skills
- Analytical skills
- Ability to work shifts varying between 8 AM and 8 PM EST
- Candidates must reside within a reasonable commuting distance from the posting location(s), unless an accommodation is granted as required by law
- New candidates in certain patient/member-facing roles must become vaccinated against COVID-19 and Influenza, unless an acceptable explanation is provided
Benefits
Comp & perks- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short-term disability benefits
- Long-term disability benefits
- 401(k) with company match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
- Virtual full-time work, except for required in-person training sessions
- Flexible work-life integration and autonomy