Pharmacy Specialist I

Company: VirtualVocations
Location: Milwaukee
Posted on: November 20, 2024

Job Description:

A company is looking for a Pharmacy Specialist I to manage prior authorization requests and support Pharmacy Services benefits.

Key Responsibilities:

Handle telephonic interactions regarding Pharmacy eligibility, coverage determinations, and claim issues
Capture clinical information for Prior Authorization requests and evaluate medical necessity
Process complaints, appeals, and identify instances of potential fraud, waste, and abuse

Required Qualifications, Training, and Education:

High School Diploma/GED required
Minimum of two (2) years experience as a Pharmacy technician
National Pharmacy Technician Certification (PTCB or ExCPT) required
Knowledge of third-party prescription program claim adjudication
Understanding of National Drug Code (NDC) and relevant state regulations

Keywords: VirtualVocations, Arlington Heights , Pharmacy Specialist I, Healthcare , Milwaukee, Illinois

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