Remote Pharmacy Technician (Prior Authorization)

CSpring is actively searching for a full-time Remote Pharmacy Technician to support our Prior Authorization team with Indiana Medicaid Rx. The ideal candidate is looking to move out of a retail Rx setting and into a professional environment. This position starts at $15.00 per hour with full benefits, paid holidays, and PTO on day one. Hours are 10:00-6:30 Monday-Friday and 8:00-4:30 on Saturday. Allowing day of choice off through the week to compensate Saturday hours.
If the idea of working on challenging assignments with a team who is passionate about serving others and creating insights sounds exciting, this may just be the role you've been looking for!
**Please note that this position is only open to Indiana residents.**
Position Summary
Our Medicaid Rx Customer Service Center provides advanced inbound customer service for all Indiana Medicaid members and providers who have questions regarding pharmacy coverage and claims processing. As a Pharmacy Technician, you will utilize multi-line phones to respond to inquiries concerning in-network pharmacy locations, general coverage inquiries, and medication pricing.
Responsibilities

• Prep, review, and approve/deny requests for prescription Prior Authorization and/or appeal
• Scan, index and prepare documents related to Prior Authorization and/or appeal request, verifying and updating patient/member profile information
• Compile medical notes (disease state, drug treatment history and current drug plan) from patient/provider in support of the request, review request against decision tree and approval protocol, and perform outreach for additional information as needed to support the request
• Update approved requests in claims systems and inform patient/provider of approval
• Forward applicable requests through additional review path as needed
• Ensures Rx denial is communicated to patient/provider along with rationale

Requirements

• High school diploma
• 1-2 years of prior pharmacy experience (retail, LTC, hospital, etc.)
• Must have a valid Indiana Pharmacy Technician license
• Must have a valid national CPhT certification, or the ability to obtain within six months of hire
• Proficiency with computers, software systems, data entry, and Microsoft Office suite
• Strong time management, including the ability to organize and manage multiple priorities
• Strong customer-orientation
• Self-motivated to complete tasks on time
• Positive attitude
• Excellent interpersonal and communication skills
• Dedication to company values: Committed, Collaborative, Consultative, Caring
• Ability to pass E-Verify, a criminal background screen, and a pre-employment drug screen
• Ability to work overtime as needed to support department goals

Preferred Qualifications

• Prior experience working with Medicaid and/or with government healthcare
• Prior experience working in remote setting
• Call center experience
• Inbound/outbound call experience in any pharmacy setting

About CSpring
CSpring is a growing, Indianapolis-based technology consulting firm focused on data-driven solutions. Our team aligns business goals with technology to make information accessible, reliable, and engaging via custom and integrated software, data platforms, and advanced analytics.
If you are committed, collaborative, consultative, and caring - you will fit right in with our team. We pride ourselves in working together and understand that the whole is stronger than any one of us individually. When you join CSpring, you become part of our family - our Ohana. When you're part of our Ohana, we promise to communicate well, provide opportunities for growth, and most importantly, celebrate our successes together. Being part of CSpring's Ohana means you will be informed, recognized, rewarded, and respected. You will also have lots of opportunity to develop strong relationships with our team at quarterly company update events, monthly outings, community service opportunities, learning lunches, and more.
CSpring offers a comprehensive compensation, training, and benefits package; including Paid Time Off, Medical/Dental/Vision/Life/Disability insurance on day one, and 401(k) with company match.
Salary Description
15.00 hr.