?Under the general supervision of the Supervisor of Pharmacy Prior Authorization Technicians, the Pharmacy Services Technician I assists in the prior authorization process.
? Reviews and approves physician inquiries for pre-authorization and medical necessity requests based on established pharmacy guidelines and contract criteria.
? Supports Fraud and Abuse program system oversight by reviewing medication utilization records. Communicates any suspected fraud discovered.
? Recommends course of action for providers where patterns appears outside of guidelines and generally accepted pharmacy standards.
? Keeps abreast of industry trends and regulatory changes in the pharmacy industry and incorporates knowledge in the performance of job duties. Identifies problems in process/procedures or services and makes recommendations for improvements. Maintains a balance of productivity, quality and timeliness of job accountabilities. Participates in department self-audit procedures for on-going evaluation of service.
? Maintains and updates internal databases. Enters application information, prior authorizations and other relevant data.
? Ensures database information and appended files are current and accessible to staff. Generates reports and other information requested on a scheduled/as needed basis.
? Creates and supports an environment which fosters teamwork, cooperation, respect and diversity. Establishes and maintains positive communication and professional demeanor with AMFC employees and clients at all times.
? Performs other related duties as assigned.
? Attends required training on an annual basis.
? Minimum 2 years previous pharmacy experience
? Minimum 35 words per minute typing speed
? Current Pharmacy technician certification (PTCB or NCCT)
? High School Graduate or GED equivalent.