Support members, providers, and pharmacies by responding to pharmacy-related inquiries, benefit questions, prior authorization requests, and claims-related issues
Research and resolve pharmacy claims, eligibility, coverage, and medication-related concerns while maintaining service level expectations
Review, document, and process pharmacy transactions and requests in accordance with client, regulatory, and operational guidelines
Utilize multiple systems and resources to accurately investigate issues, provide resolutions, and maintain complete documentation
Collaborate with internal teams, healthcare professionals, and external stakeholders to support quality service delivery and member satisfaction

Active Certified Pharmacy Technician (CPhT) certification required
Active Pharmacy Technician registration with a State Board of Pharmacy, where applicable
Experience supporting pharmacy operations, prior authorizations, pharmacy claims, PBM services, managed care programs, specialty pharmacy, or healthcare customer service preferred
Strong customer service, communication, and problem-solving skills with the ability to work effectively in a fast-paced, high-volume environment
Proficiency using pharmacy systems, multiple computer applications, and documentation tools while maintaining accuracy and attention to detail

Certified Pharmacy Technician

Key skills