the drugstore Technician approaches earlier authorization requests and conducts medical studies to aid evaluations. additionally they manipulate inquiry calls and make sure well timed documentation of approvals and denials.
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as the country’s leading health solutions business enterprise, we reach hundreds of thousands of american citizens via our nearby presence, virtual channels and greater than three hundred,000 motive–pushed colleagues – caring for human beings where, when and how they select in a manner that is uniquely greater linked, extra handy and greater compassionate. And we do it all with heart, each and each day.
function precis
– techniques previous authorization requests received through cellphone, fax, or electronically and utilizes numerous pc assets, existing standards, and medication recommendations to perform clinical research to support earlier authorization critiques.
– Proactively completes prior authorization approvals and denials that are because of expire and keeps entire, well timed, and accurate documentation.
– critiques capability earlier authorization denial language to ensure NCQA requirements are met.
– Follows prior authorization workflow, guidelines, and approaches all through the path of the workday.
– answers a probably excessive extent of earlier authorization inquiry calls from issuer‘s offices, pharmacies, and inner companions and makes use of diverse computer resources to talk prior authorization repute or decisions.
– continues a stability of productivity, first-rate, and timeliness of labor.
– Participates in training and persevering with education as required.
– Participates in crew/departmental meetings as required.
– remarkable attendance is a need to.
– a success pharmacy technicians may be proficient in drug name and analysis pronunciation, spotting scientific terminology, and navigating more than one pc resources to report conversations and prior authorization decisions.
– successful pharmacy technicians will possess appropriate written and verbal verbal exchange abilities.
– Hours of operation for Aetna Pharmacy earlier Authorization are between five:00am to 7:00pm (may additionally vary by means of time sector). Pharmacy Technicians work eight hours shifts which could fall in among these hours of operations. in a single day shifts may also be available, however now not guaranteed. paintings time table is approximate, and hours/days may alternate based on organization needs. All full-time employees are required to finish forty (40) hours according to week as scheduled, including on weekends and vacations. component time positions aren’t available. position calls for the capacity to work prolonged hours while important.
– Rotating weekend time table may be required.
– Candidate have to have their personal home internet access with minimal pace of 100mbps download (net may be difficult stressed with Ethernet twine).
– Candidate must actually have a at ease workspace/office in their home.
– Candidate have to have excessive stage skill with working with computer (ex. using mouse and keyboard, accessing, and navigating via multiple systems and displays).
physical needs: frequent speaking and listening the use of a headset, sitting for long intervals of time operating at a pc, use of hands and hands throughout keyboard or mouse, using laptop monitors for up to 3 hours without a ruin.
The physical needs and work surroundings characteristics described herein are consultant of these that have to be met by means of an worker to successfully carry out the essential features of this task. affordable inns can be made to permit individuals with disabilities to perform the vital features.
Required qualifications
– national Pharmacy Technician certification and relevant nation Pharmacy Technician license, modern-day and in desirable standing, are required and need to be maintained.
– between 1-5+ years of Pharmacy previous Authorization processing revel in.
– capacity to Multi-project and prioritize work.
– capacity to adjust based totally on commercial enterprise or department wishes.
– exact business enterprise competencies
favored qualifications
– Retail or health center enjoy
– controlled Care or Medicaid revel in
– AS400 enjoy
– skillability in using automated sources and software applications
– talent with Microsoft programs (Excel, phrase, and Outlook)
– information in pharmacy practices, procedures, and capacity to examine and understand clinical facts
– working know-how of drug dosage bureaucracy, drug electricity, common and brand call equal.
