Pharmacy Technician II - (Fresno, CA)

HourlyPosition Purpose: Track and triage all coverage determination requests for prior authorizations and Medicare Part D recipients Track and triage coverage determination requests submitted from providers and determine if a pharmacist review is required Obtain verbal authorizations and request detailed clinical info from prescribers Approve coverage determination requests based on defined criteria Enter and document coverage determination request decision into the PBM system and notify providers and/or members Respond to client inquiries regarding authorization approvals and PBM online applications Refer coverage determination requests for specialty drugs to delegated vendor or client for processing Contact providers for additional info to facilitate coverage determination reviews Notify physicians, providers and members of coverage determination request decisions