Tech Pharmacy Health Plan
4 days ago
Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make. Job Posting Title Tech Pharmacy Health Plan **Job Description**: The Pharmacy Technician Health Plan is responsible for working with the Paper Claims staff to identify equivalent U.S. product information for the handling of foreign claims. This role is responsible for providing National Drug Code (NDC), National Provider Identifier (NPI), and National Association of Boards of Pharmacy (NABP) numbers, quantities, and/or day supply information needed for manual claims processing. **Responsibilities**: - Research, select, and document equivalent U.S. drug product for processing of foreign paper claims - Create and maintain current foreign and compound claims processing policies and procedures - Maintain and research correct drug information for processing vendor and provide appropriate NDC, NPI and NABP numbers, quantities, and day supply information for manual claims processing - Contact pharmacies to verify members’ claim information - Review various claims reports and partner cross functionally on research and issue resolution - Process exception claims to meet client performance guarantees - Other duties as assigned Minimum Qualifications - High school diploma from an accredited school or equivalent GED - 2 years of work experience in the retail or hospital industry - Current registration with State Board of Pharmacy in the State where the position is located - National Pharmacy Technician Certification through PTCB or ExCPT (CPhT) - Must be eligible to work in the United States without need for work visa or residency sponsorship Additional Qualifications - Strong verbal and written communication skills - Ability to manage multiple priorities simultaneously - Proven knowledge of drugs for drug categorization Preferred Qualifications - Understanding of point of sale, online pharmacy claims processing environment - Previous work experience in the PBM or managed care industry Minimum Physical Job Requirements - Ability to work a flexible schedule including weekends, holidays, overtime, on call, and shifts outside of Prime’s core business hours of 9:00 a.m. to 3:00 p.m. - Ability to spend at least 25% of work day on telephone contacting pharmacies - Constantly required to sit, use hands to handle or feel, talk and hear - Frequently required to reach with hands and arms - Occasionally required to stand, walk and stoop, kneel, and crouch - Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds - Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus Reporting Structure - Reports to a Supervisor in the PBM Operations department Potential pay for this position ranges from $18.46 - $23.94 based on location, experience and skills. - To review our Benefits, Incentives and Additional Compensation, visit our - Benefits Page - and click on the "Benefits at a glance" button for more detail.
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