Engagement Description - PA Specialist in Pt B Pharmacy will support providers (physicians and other healthcare providers rendering medical care) with Medicare Part B drug coverage inquiries, and prior authorizations.

Top 3 Required Skills/Experience -

• 2-4 years Specialty and/or Retail Pharmacy

• Experience in provider/member call center or helpdesk

• Process prior authorization requests

Required Skills/Experience - The rest of the required skills/experience. Include:

• Knowledge of specialty prescription drug names, NDC drug codes, therapeutic classes and claims processing preferred

• Call Center or Helpdesk experience. Ability to communicate effectively with providers and members.

• Analyzing written, faxed, and verbal inquiries which may lead to entry of medical authorizations into the online provider facing webtool.

Preferred Skills/Experience - Optional but preferred skills/experience. Include:

• Prior Authorization on Pt B specialty medications

• Knowledge or pricing NOC drugs

• Familiarity with Medicare Guidelines and Timeframes

• Knowledge of pharmacy and/or medical claims processing

• Proficient in Microsoft Office Products

Education/Certifications - Include:

• High School Graduate of GED equivalent required. Two (2) years of college preferred.

• Pharmacy Technician Certification (PTCB) preferred

Category Sales

Function Clerical / Administrative

Req ID JN -042024-121090