Senior Pharm PA/Appeals Technician - Remote in Texas, New Mexico, & Kansas
UnitedHealth Group
- Sugar Land, TX
- Permanent
- Full-time
- Primarily answering prior authorization with inbound calls (up to 50 to 70 calls per day) from providers/members as well as research and resolve formulary and benefit issues using the appropriate reference material
- Process authorizations through various computer systems and use of job aid/policies/procedures ensuring the accuracy of all data and updating as necessary
- Have sharp attention to detail, using established criteria and guidelines, the pharmacy technician receives and processes prior authorization requests made by providers and members for medications not inherently covered on a member's prescription drug plan
- Patient Safety and Quality of work is paramount and it’s important for employees to have a safe and secure workspace and communicate with their leadership when that safety (equipment, system, information) is compromised
- Resolve issues and complaints in a timely manner
- Performs other duties as assigned by management
- Handles inbound phone requests and gathers member data to provide information for pharmacist consultations
- Training is for 5 weeks. Training time is 8:00am-5:00pm local time. Monday- Friday. This training time is subject to change
- Shift after training is an 8-hour shift with an hour lunch. Candidate must be available as early as 5am and as late as midnight
- Candidate will work 5 days a week which may or may not include a weekend day(s)
- There may be scheduled overtime and/or working on holidays dependent on business needs
- Candidate must have their own home internet access (internet can be hard wired with Ethernet cord)
- Candidate must also have a secure workspace/office in their home
- Candidate must have level skill with working with PC (ex. using mouse and keyboard, accessing, and navigating through multiple systems and screens)
- Excellent attendance is a must
- Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays + Floating Holiday
- Medical Plan options along with participation in a Health Spending Account or a Health Saving account
- Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
- 401(k) Savings Plan, Employee Stock Purchase Plan
- Education Reimbursement
- Employee Discounts
- Employee Assistance Program
- Employee Referral Bonus Program
- Flexible Work Arrangement
- Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
- More information can be downloaded at:
- Licensure Requirement - Must have one of the following active and unrestricted licensure/certifications:
- Pharmacy Technicians Certification Board (PTCB)
- State Board of Pharmacy Licensure in state of residence
- ExCPT – Pharmacy Technician Certification with National Healthcareer Association (NHA)
- The National Board of Prior Authorization Specialist
- 6+ months of Customer Service/Customer Relations experience with healthcare professionals
- Basic level of proficiency with Microsoft Excel (ability to create, edit, and save a basic spreadsheet), Microsoft Word (ability to create, edit, and save a basic document), and Microsoft Outlook (ability to send emails)
- Ability to work any shift in the 7:00 AM to 12:00 AM timeframe with flexible hours, including OT and weekends
- Knowledge of Call Center systems such as IEX
- Experience and strong communication skills, both written and oral that will help improve Net Promoter Survey (NPS)
- Ability to follow through on tasks
- Physical Requirements and Work Environment:
- Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer
- Ability to have their own home internet access (internet can be hard wired with ethernet cord)
- Have a secure workspace/office in their home
- Have level skill with working with PC (ex. using mouse and keyboard, accessing, and navigating through multiple systems and screens)