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Prior Authorization Technician

Ohm Systems, Inc

Remote • Today

Easy Apply

Contract

25 - 28

PCBA Test Technician

Mastech Digital

New York, New York • Today

Easy Apply

Contract

$25.00 - $29.00 per hour

Quality Assurance Lab Technician

Stefanini

Wyandotte, Michigan • Today

Easy Apply

Contract

$22 - $23 /hr

Quality Assurance Lab Tech

Stefanini

Attapulgus, Georgia • Today

Easy Apply

Contract

$25 - $27 /hr

Pharmacy Technician I

Ohm Systems, Inc

Remote • Today

Easy Apply

Contract

25 - 28

Test Technician

Jobot

Long Beach, California • Today

Full-time

USD 70,000.00 - 100,000.00 per year

Product Test Technician

EnPro Industries

Longview, Texas • Today

Full-time

Product Test Technician

Texas Instruments Incorporated

Lehi, Utah • Today

Full-time

Equipment Preparation and Installation Technician

Sodexo

Gilbert, Arizona • Today

Full-time

Compensation information provided in the description

Equipment Preparation and Installation Technician

Sodexo

Pflugerville, Texas • Today

Full-time

Compensation information provided in the description

Preventative Maintenance Technician

Waste Connections

Placerville, California • Today

Full-time

Compensation information provided in the description

Quality Technician

TruCut Incorporated

Salem, Ohio • Today

Full-time

Quality Technician

Manpower

Asheville, North Carolina • Today

Full-time

Compensation information provided in the description

Quality Technician

Ducommun, Inc.

Appleton, Wisconsin • Today

Full-time

Quality Technician

Torito Brands

Tallahassee, Florida • Yesterday

Full-time

USD 50,000.00 - 55,000.00 per year

Quality Assurance Technician

Kforce Technology Staffing

North Reading, Massachusetts • Today

Contract

$48 - $53 hourly

Quality Assurance Technician

Choctaw Global

McAlester, Oklahoma • Yesterday

Full-time

USD 22.00 - 25.00 per hour

Access Control Technician

Robert Half

Summerville, South Carolina • Today

Easy Apply

Full-time

USD 25.00 - 30.00 per hour

Process Set-Up Technician

Advantage Technical

Middletown, Ohio • Today

Full-time

USD 32.00 - 38.00 per hour

Test Technician

Johnson Controls

Burlington, Massachusetts • Today

Full-time

Compensation information provided in the description

Test Technician

ABM Industries

Austin, Texas • Today

Full-time

Post Market Quality Technician

Apex Systems

Acton, Massachusetts • Today

Easy Apply

Full-time

$32 - $32 per hour

Data Prep Technician

Emery Sapp and Sons, Inc.

Kansas City, Missouri • Today

Full-time

Test Technician

Ducommun, Inc.

Appleton, Wisconsin • Today

Full-time

Test Technician

Toyota Material Handling North America

Greene, New York • Today

Easy Apply

Full-time

Compensation information provided in the description

Software Configuration Tech - Clearance Required

LMI Government Consulting (Logistics Management In

Remote • Today

Contract

USD 130,000.00 per year

Ohm Systems, Inc

Job Details

Skills

Adaptability
Authorization
Pharmacy
Pharmaceuticals
Managed Care
PTCB
Certified Pharmacy Technician
Retail
Litecoin
Multitasking
Policies and Procedures
Customer Service
Productivity

Summary

Duties

Reporting directly to the Supervisor, Prior Authorization Technicians, the Prior Authorization Technician I processes prior authorization requests received from providers, members, and pharmacies, including requests for high cost and specialty medications.

Essential Functions

Interprets and applies clinical criteria during the prior authorization review process and approves requests if applicable.
Utilizes member claims history during the prior authorization review process.
Makes outbound calls to obtain additional information needed to process prior authorization requests.
Submits authorizations to pharmacy and medical claims processors.
Forwards prior authorization requests to a pharmacist when necessary.
Makes appropriate referrals to other clinical programs.
Assists in directing appropriate requests to in network providers.
Receives inbound calls from the customer care center with prior authorization related inquiries.
Assist with Appeals processing as assigned.
Ability to multitask between various tasks and systems while maintaining required productivity and quality levels.
Ability to make changes in a fast-paced environment.
Strong knowledge of specialty and non-specialty pharmaceuticals.
Performs other job-related duties and projects as assigned.
Attends required training on an annual basis.
Adheres to corporate and departmental policies and procedures.
Available to work weekends and holidays.

Skills

1 to 3 Years required.
Previous PBM, managed care, hospital pharmacy, LTC pharmacy, Home Infusion pharmacy, retail pharmacy experience preferred.
Minimum 35 words per minute typing speed.
Prior Authorization Processing.
Clinical Criteria Interpretation.
Member Claims History Utilization.
Outbound Calling.
Authorization Submission.
Additional.
Referral Management.
Appeals Processing.
Multitasking.
Adaptability.
Specialty Pharmaceuticals Knowledge.
Non-Specialty Pharmaceuticals Knowledge.
PBM Experience.
Managed Care Experience.
Hospital Pharmacy Experience.
LTC Pharmacy Experience.
Home Infusion Pharmacy Experience.
Retail Pharmacy Experience.

Education

High School/GED Required.
Certified Pharmacy Technician (PTCB or NHA).
May be required to be licensed or certified in a specific state based upon contractual requirements and business need.
Requires working shift schedule outside standard business hours.
Must remain in stationary position for long periods of time at desk or computer.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: 10111826
Position Id: 9056858
Posted 1 hour ago

Company Info

About Ohm Systems, Inc

Ohm Systems, Inc. specializes in IT and Healthcare staffing services, dedicated to linking highly skilled professionals with our public and private clients across the United States. Our track record showcases our commitment to delivering outstanding staffing and consultancy solutions to our clients. We prioritize diversity and inclusivity and take pride in being an employer that promotes equal opportunities and affirmative action. Our goal is to foster an inclusive work environment that embraces individuals from all backgrounds, irrespective of their gender, race, or orientation.

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Jay Khatri

Recruiter @ Ohm Systems, Inc

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Pharmacy Technician I

Remote

•

Today

The position and the compensation details are listed below:Client: AmeriHealth CaritasHourly Pay: $28.50/Hr. On W2Benefits: None. This is a temporary consulting/contract position without any benefits.Title: Prior Authorization Technician ILocation: Client is located Philadelphia, PA - 100% RemoteDuration: 3-month contractWork Mode: RemoteShift Position is remote. No time zone preference but shift times offered will be in EST time so candidates will need to adjust accordingly if in a different t

Easy Apply

Contract

25 - 28

Pharmacist

Remote

•

Yesterday

Shift Shift Schedule: Monday through Friday 10:00 AM to 6:30 PM with a possible Sat rotation if business needs dictate.The shift time may be subject to change based on business needs. Duties As a licensed healthcare professional employed in the Prior Authorization Department the primary responsibility of Pharmacist (R) is to make determinations on prior authorization requests for coverage of pharmaceutical products.Determinations include medical necessity and benefit decisions.Decisions are made

Easy Apply

Contract

65 - 70

Ohm Systems, Inc

Job Details

Skills

Adaptability
Authorization
Pharmacy
Pharmaceuticals
Managed Care
PTCB
Certified Pharmacy Technician
Retail
Litecoin
Multitasking
Policies and Procedures
Customer Service
Productivity

Summary

Duties

Reporting directly to the Supervisor, Prior Authorization Technicians, the Prior Authorization Technician I processes prior authorization requests received from providers, members, and pharmacies, including requests for high cost and specialty medications.

Essential Functions

Interprets and applies clinical criteria during the prior authorization review process and approves requests if applicable.
Utilizes member claims history during the prior authorization review process.
Makes outbound calls to obtain additional information needed to process prior authorization requests.
Submits authorizations to pharmacy and medical claims processors.
Forwards prior authorization requests to a pharmacist when necessary.
Makes appropriate referrals to other clinical programs.
Assists in directing appropriate requests to in network providers.
Receives inbound calls from the customer care center with prior authorization related inquiries.
Assist with Appeals processing as assigned.
Ability to multitask between various tasks and systems while maintaining required productivity and quality levels.
Ability to make changes in a fast-paced environment.
Strong knowledge of specialty and non-specialty pharmaceuticals.
Performs other job-related duties and projects as assigned.
Attends required training on an annual basis.
Adheres to corporate and departmental policies and procedures.
Available to work weekends and holidays.

Skills

1 to 3 Years required.
Previous PBM, managed care, hospital pharmacy, LTC pharmacy, Home Infusion pharmacy, retail pharmacy experience preferred.
Minimum 35 words per minute typing speed.
Prior Authorization Processing.
Clinical Criteria Interpretation.
Member Claims History Utilization.
Outbound Calling.
Authorization Submission.
Additional.
Referral Management.
Appeals Processing.
Multitasking.
Adaptability.
Specialty Pharmaceuticals Knowledge.
Non-Specialty Pharmaceuticals Knowledge.
PBM Experience.
Managed Care Experience.
Hospital Pharmacy Experience.
LTC Pharmacy Experience.
Home Infusion Pharmacy Experience.
Retail Pharmacy Experience.

Education

High School/GED Required.
Certified Pharmacy Technician (PTCB or NHA).
May be required to be licensed or certified in a specific state based upon contractual requirements and business need.
Requires working shift schedule outside standard business hours.
Must remain in stationary position for long periods of time at desk or computer.

Dice Id: 10111826
Position Id: 9056858
Posted 1 hour ago

Company Info

About Ohm Systems, Inc

Go to company profile

Fitment

Dice Job Match Score™

🧠 Analyzing your skills...

Contact the job poster

Jay Khatri

Recruiter @ Ohm Systems, Inc

View Profile

Create job alert

Never miss an opportunity! Create an alert based on the job you applied for.

Similar Jobs

Pharmacy Technician I

Remote

•

Today

Easy Apply

Contract

25 - 28

Pharmacist

Remote

•

Yesterday

Easy Apply

Contract

65 - 70