New York Certified Appeals Technician

A company is looking for an Appeals Technician responsible for managing incoming requests for appeals while ensuring high customer service and productivity.

Key Responsibilities

Maintain quality and productivity standards for all reviewed cases while meeting turnaround time requirements

Review cases to verify qualifications for appeal review and perform quality checks in accordance with policies

Communicate with appeal pharmacists and perform outreach to gather necessary information for case reviews

Required Qualifications

1+ years of experience as a certified pharmacy technician in a managed care or PBM setting

Active, unrestricted certified pharmacy technician license

Experience working in a remote, high-volume, metric-driven environment

Ability to work independently with minimal supervision

Experience with commercial and Medicare appeals is preferred