Engagement Description – PA Specialist in Pt B Pharmacy will support providers (physicians and other healthcare providers rendering medical care) with Medicare Part B drug coverage inquiries, and prior authorizations.
Top 3 Required Skills/Experience –
• 2-4 years Specialty and/or Retail Pharmacy
• Experience in provider/member call center or helpdesk
• Process prior authorization requests
Required Skills/Experience – The rest of the required skills/experience. Include:
• Knowledge of specialty prescription drug names, NDC drug codes, therapeutic classes and claims processing preferred
• Call Center or Helpdesk experience. Ability to communicate effectively with providers and members.
• Analyzing written, faxed, and verbal inquiries which may lead to entry of medical authorizations into the online provider facing webtool.
Preferred Skills/Experience – Optional but preferred skills/experience. Include:
• Prior Authorization on Pt B specialty medications
• Knowledge or pricing NOC drugs
• Familiarity with Medicare Guidelines and Timeframes
• Knowledge of pharmacy and/or medical claims processing
• Proficient in Microsoft Office Products
Education/Certifications – Include:
• High School Graduate of GED equivalent required. Two (2) years of college preferred.
• Pharmacy Technician Certification (PTCB) preferred
Function Information Technology
Req ID JN -092023-120473