Job Details

Contract - 12 Months
Certified Pharmacy Tech 1

Start Date: 08/04/2025

Must Haves:

Retail Experience
Call Center Experience is a Plus
MUST HAVE PTCB Certification! No other certs will be accepted.

Job Description Summary

A Certified Technician in a call center evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile (fax) using client clinical criteria in a call center environment.

Job Description

• Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists.
• Research, resolves, and documents prior authorization outcomes in pharmacy system.
• Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists.
• Escalates requests to Pharmacist when request requires extensive clinical review or denial.
• Research, resolves, and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider, and/or management.
• Performs other duties as required.
• For CPTs assigned to work the fax queue, responsibilities will also include:
• Clinically reviews coverage determinations with attention to detail, for medications via Fax. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists within SLA (service level agreement) guidelines.
• Efficiently multi-tasks and monitors several queues and assignments. Adapts to team requirements as business needs change (e.g., fax work, pending queues, oral notifications, and failed faxes).