Certified Pharmacy Technician

Job Description

Please find below the details :

Position : Pharmacy Services Specialist

Location : Onsite – Orange, CA 92868

Duration : 6 months (Possibilities of extensions / conversion)

Shift : Day 5x8-Hour

Schedule : Monday to Friday, 8 : 00 a.m. – 5 : 00 p.m.

Position Summary :

We are seeking a Pharmacy Technician for a full-time temporary role supporting Medicare Part D beneficiaries. This position will focus on pharmacy-related program support, case management, and assisting network pharmacies and providers with claims, billing, and authorization processes.

Key Responsibilities :

• Manage caseloads to ensure resolution of member and pharmacy cases within department standards.
• Assist with drug-specific technical data retrieval and pharmacy operations.
• Support network pharmacies and prescribers with billing, claims processing, eligibility, and authorization issues.
• Resolve pharmacy claims disputes involving various departments and external entities.
• Interpret and communicate Pharmacy program policies and procedures to providers and staff.
• Process pharmaceutical prior authorization and appeals requests per guidelines.
• Coordinate pharmacy services with internal teams and external providers.
• Handle pharmacy-related member complaints and assist in resolving prior authorization requests.
• Complete other assigned projects and duties.

Minimum Qualifications :

Preferred Qualifications :

Skills & Abilities :