DataStaff is currently seeking a Pharmacy Technician for a contract to hire opportunity with one of our direct clients in Raleigh, NC. All applicants must be registered Pharmacy Technicians with the State of North Carolina or willing to transfer to NCBOP.
Shift hours: 9 am - 5:30 pm
This position will be remote due to COVID and once restrictions are lifted in the area the position will move to the local on-site office, however initial training may be on-site for the first week.
This position requires you to have a professional, quiet workspace, free from distractions and interruptions as PHI data may be reviewed and HIPAA guidelines will be in place. High-speed internet capability is also required.
In addition, you will be required to work 1 weekend every 4 to 6 weeks and holiday shifts are required and will be rotated amongst the team. Night coverage may be needed as well from time to time.
- Performs reviews of prior approval requests submitted by enrolled providers.
- Escalates problems to appropriate personnel when needed.
- Performing under North Carolina's approved criteria that outline policies and requirements this position determines prior approval for specific procedures.
- Answers incoming provider calls regarding prior approval request processing. Documents prior approval requests and associated history.
- Evaluates available information to validate prior approval requests.
- Verifies policyholder information, policy effective dates, premium status and verification of prior approval request eligibility.
- Sends prior approval request form to the provider for updating, correction or completion.
- Investigates simple to moderately complex prior approval request and determines level or resolution if appropriate; advises provider of status; assists in negotiating settlement and resolution of prior approval request.
- Identifies the need for additional information; contacts appropriate source to obtain needed information.
- Performs review of prior approval requests for the pharmacy program.
- Registered Pharmacy Technician in the State of North Carolina.
- High School Diploma or graduate equivalent degree.
- At least 1 year of pharmacy experience or pharmacy technician training or certification preferred.
- Knowledge of medical and drug terminology and pharmaceutical calculations.
- Knowledge of third-party insurance and payment options.
- Basic computer skills including dual-screen use, copy + paste, and accurate typing at speed of at least 45 WPM.
- National Pharmacy Technician Certified.
- 2 years' health care experience in call center environment.
This position is available as a W2 position with a competitive benefits package. DataStaff offers medical, dental, and vision coverage options as well as paid vacation, sick, and holiday leave. As many of our projects are long-term, we also have a 401k program available for employees after 6 months.