Remote Associate Pharmacy Clerk

Job Description

Job Description

Pay rate is 15.50

Training is for 2 weeks. Training time is 8 : 00am-4 : 30pm CST. Monday- Friday.

Description / Job Duties :

• Indexing agent : data entry; they are grabbing the fax images that are received from their providers and are looking for specific information; don't need to read everything but needs to be able to identify the members information, provider, medication they are requesting, any sense of urgency
• Some type of pharmacy background
• Entering drug information, identifying syringe, capsule, tablet
• Outbound calls : dual trained position, if there is no work for the day will be trained in outbound calls to make phone calls but ideally they won't really use them to do the calls; might be an

hour once per month; would be calling out to let them know the results of the prior authorization if it was approved or denied; just on the drug piece

Primary Responsibilities :

Sort electronic copies of incoming fax transmittals and index them into the appropriate Prior Authorization System PAS workbaskets

Research and identifying member provider and drug information across multiple computer systems

Review Incoming PA faxes and initiate coverage determination requests in a timely manner within SLA

Perform outbound calls to Providers and / or Members to obtain additional information to resolve Prior Authorization cases. Perform outbound call to Providers and / or to inform them of the outcome of Prior Authorization cases.

Additional Responsibilities :

Navigate across multiple computer systems to identify information needed for outbound calls to members / providers.

Make outgoing calls as needed to provide information on prior authorization case outcome follow-up or consultation such as prior authorization requirements appeals etc.

Educate members / guardians providers pharmacy staff on procedures to avoid compliance risk.

Meet departmental established performance expectations and working independently to complete tasks in a timely manner.

May include processing member prior authorizations through various computer systems ensuring the accuracy of all data and updating as necessary.

May take incoming calls from members or providers and apply benefit plan criteria in making decisions approvals / denials or recommendations clarify and explain pharmaceutical benefits and procedures.

May partner with others to gather additional information and / or to interpret clinical guidelines act as a resource for others

Incumbents typically are not licensed pharmacy technicians.

May include licensed pharmacy technicians doing non-technician work

Training, Procedures, Research, Review, Inbound Outbound Calls, About Time, Internet, Benefit Functions, Hiring Processes, Communication Skills, Clinical Trial Operations, Attendance, Computer System, Distribute Faxes, Appeals, Pharmacy, PC OS, Offshore, Service Level Agreements, VPN Technologies, Consultation, Denials, Overtime, Fax, Language Interpretation