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Hours Full-time, Part-time
Location Saint Louis, MO
Saint Louis, Missouri

About this job

Description

Anthem, Inc. is one of the nation's leading health benefits companies and a Fortune Top 50 company. At Anthem, Inc., we are working together to transform health care with trusted and caring solutions.

Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people's lives, and to take your career further than you can imagine.

The Pharmacy Tech I is responsible for the interpretation and data entry of basic prescriptions, prior authorization processing, and troubleshooting adjudication issues.

Primary duties may include, but not limited to:

* Verifies member information and inputs data for the pharmacists.

* Educates members on pharmacy based rules related to prescriptions and medication resources or assistance programs.

* Processes prior authorization requests from physicians' offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations.

* Provides resolution to grievances and appeals issues.

* Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.

* Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports.

* Maintains record keeping of prior authorizations, rebates, and monthly reports.

The Pharmacy Tech II is responsible for educating members on medication as related to prescriptions; advising members of available resources and assistance programs; interpreting moderately complex prescriptions.

Primary duties may include, but are not limited to:

* Processes prior authorization requests from physicians' offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations.

* Enters and validates information on member prescriptions and reviews member prescriptions in claims system

* Place outbound and receive inbound calls to consult and educate members on Medication Therapy Awareness

* Compile and document accurate outreach to members

The Pharmacy Technicians employs intellectual, interpersonal and technical skills through the utilization of the pharmacy process to assist members in achieving and maintaining maximum health potential.

Hours: This location operates 24 hours a day/7 days a week including holidays and weekends. Starting time of the position is anywhere from 8AM - 12PM.

Qualifications

Qualifications

Pharmacy Tech I requires a high school diploma; 1 year of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.

Current State Pharmacy Tech. Certification or National Certification based on applicable state(s) required.

Pharmacy Tech II requires a high school diploma; 2 years of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.

Current State Pharmacy Technician License or National Certification are required.

Prior call center experience strongly preferred.

Bilingual (English/Spanish) preferred