Prior Authorization Technician II

🔥 1 minute ago

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

WellDyne

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1990

🏥 Healthcare

💊 Pharmaceuticals

⚕️ Healthcare Insurance

Healthcare • Pharmaceuticals • Healthcare Insurance

WellDyne is a pharmacy benefit management (PBM) company that provides specialty pharmacy services, prescription discount solutions, utilization management, mail-order and central fill pharmacy operations, and outsourced pharmacy solutions. The company emphasizes clinical programs, adherence initiatives, data analytics, and personalized engagement to reduce drug costs and improve outcomes, particularly for high-cost specialty medications. With about 25 years of experience and locations in Lakeland, FL and Centennial, CO, WellDyne positions itself as an alternative to traditional PBM models by offering flexible plan design, dedicated account management, and industry-focused clinical expertise.

📋 Description

• Responsible for starting clinical prior authorization requests via telephone or email. • Support prior authorization call center via administrative and clinical prior authorization support lines. • Creates and faxes cases for prior authorization, maintaining complete, timely and accurate documentation of all prior authorization requests. • Completes prior authorization request via telephone with appropriate staff at prescriber’s office by answering questions based on protocols when possible. • Works closely with pharmacies, providers, and members to resolve any questions or issues involving prior authorizations. • Responds in a prompt, professional, and courteous manner to pharmacy, provider and member inquiries regarding administrative prior authorizations. • Ability to clearly identify problems, analyze situations, and rectify pharmacy, provider, or member concerns using established procedures. • Ability to handle difficult people and problems by resolving matters in an effective and timely manner. • Responsible for clearing and following up on all messages left on prior authorization voicemail box in a timely manner. • Apply appropriate policies, procedures, and eligibility and benefit policies. • Maintains confidentiality of all PHI in compliance with state and federal law. • Consistently meets established productivity, schedule adherence, and quality standards, while maintaining a good attendance record. • Other duties as assigned.

🎯 Requirements

• Pharmacy Technician Certification strongly preferred or must be committed to obtaining PTCB Certification within 6 months of position start date • Technician registration that is active and in good-standing, as applicable based upon state requirements for technicians • At least 2 years of pharmacy related experience • At least 2 years of customer service-related experience • MS Office Suite knowledge (Which includes the ability to learn new and complex computer system applications)

🏖️ Benefits

• Medical, Dental and Vision Benefits • Medical Savings Account Options with Company match • 401K after 90 days of employment • Employee Assistance Program • Life and Supplemental insurance • Educational Reimbursement • Paid Time Off • Career Pathing