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Health Sun - Pharmacy Tech I/II - Coconut Grove, FL - PS28796 at Anthem, Inc.

Posted in Management 29 days ago.

This job brought to you by eQuest

Type: Full-Time
Location: Coconut Grove, Florida





Job Description:

Anthem, Inc. is the nation's leading health benefits company serving the needs of approximately 40 million medical members nationwide.

Your Talent. Our Vision. At HealthSun, a proud member of the Anthem, Inc. family of companies, it’s a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

 


This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

Pharmacy Technician I:

Responsible for the interpretation and data entry of basic prescriptions, prior authorization processing, and troubleshooting adjudication issues. 

Primary duties may include, but not limited to: 

 


  • Verifies member information and inputs data for the pharmacists. 

  • Educates members on pharmacy based rules related to prescriptions and medication resources or assistance programs.

  •  Processes prior authorization requests from physicians offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations. 

  • Provides resolution to grievances and appeals issues. 

  • Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits. 

  • Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports. 

  • Maintains record keeping of prior authorizations, rebates, and monthly reports. 

The Pharmacy Technician II is responsible for the interpretation and data entry of moderately complex prescriptions, prior authorization processing, and troubleshooting adjudication issues. 

Primary duties may include, but not limited to: 


  • Verifies member information and inputs data for the pharmacists.

  • Educates members on pharmacy based rules related to prescriptions and medication resources or assistance programs. 

  • Processes prior authorization requests from physicians' offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations. 

  • Provides resolution to grievances and appeals issues. 

  • Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits. 

  • Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports. 

  • Maintains record keeping of prior authorizations, rebates, and monthly reports. 

Pharmacy Technician I:


  • High School diploma

  • Minimum 1 year of pharmacy experience, or any combination of education and experience, which would provide an equivalent background. 


  • Current State Pharmacy Tech.Certification (Registered) or National Certification based on applicable state(s) required. 

  • Basic computer and written, oral and interpersonal communications skills required.

  • Prior call center experience strongly preferred.

  • Bilingual (English/Spanish) strongly preferred.

Pharmacy Technician II:


  • Requires a high school diploma.

  • 2 years of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.

  • Current, unrestricted state of Florida Pharmacy Technician License and National Certification issued by PTCB or NHA is required.

  • Good computer and written, oral and interpersonal communications skills required.

  • Prior call center experience strongly preferred.

  • Bilingual (English/Spanish) strongly preferred.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com