Pharmacy Technician Certified Representative

Job Summary

To support the processing of Medicare prior authorizations, the full-time Remote Medicare Prior Authorization Customer Service Representative will manage incoming requests, communicate with members and providers, and ensure compliance with CMS requirements while working remotely.

Key responsibilities

• Process coverage-related requests, including prior authorizations and appeals, through phone and fax channels
• Communicate professionally with members, providers, and prescribers to obtain necessary information and maintain accurate documentation
• Collaborate with pharmacists and leadership to resolve complex issues and meet departmental quality and productivity goals

Required qualifications

• High School Diploma or equivalent
• Minimum of 1 year of customer service or healthcare-related experience
• Proficiency in navigating multiple Windows-based computer systems
• Typing speed of at least 30 words per minute
• Preferred: Pharmacy Technician Certification (CPhT)