Job Description:
Specialty Pharmacy - call center environment position
• Communicate with patients to obtain information required to process prescriptions, refills, access benefits and apply charges against co-pay cards.
• Investigate and verify benefits for pharmacy and medical third-party claims for assigned cases.
• Obtain prior authorizations; initiate requests, track progress, and expedite responses from
insurance carriers and other payers, and maintain contact with patients/customers to keep them
continuously informed.
• Review for accuracy of prescribed treatment regimen prior to submission of authorization.
• Facilitate appeals process between the patient, physician, and insurance company.
• Compose clinical appeals letters based off specific denial reason and patient’s clinical presentation.
• Coordinate appointment of representative document.
• Complete status check with insurance company regarding receipt/outcome of prior authorization
and appeal.
• Obtain approval information and activate copay cards based off eligibility and specific
drug prescribed.
Location - On-Site:
Miami, FL (33122) - close to MIA
Schedule:
Monday - Friday; 1st shift (9am-5:30pm) or 2nd shift (10:30am-7pm)
One Saturday & one Sunday a month (10am-2pm)
Must have:
Registered with State of Florida Board of Pharmacy as a Pharmacy Technician
2+ years pharmacy technician experience
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