Pharmacy Technician

CSRA

(Raleigh, North Carolina)
Full Time
Job Posting Details
About CSRA
Every day CSRA makes a difference in how the government serves our country and our citizens. We are inspired by the important missions of our customers and we believe that by working together we can deliver exceptional solutions and services to enable the safety, security, health and well-being of our nation.
Summary
CSRA is seeking a Pharmacy Technician to support the NCMMIS - Medicaid Management Information System Replacement project. As the largest pure-play IT services provider serving the U.S. government sector, CSRA is where you can come to be successful. Join a collaborative team, solving customer issues and accessing an array of resources for your success. Take advantage of tremendous opportunities as you help us chart our path to industry leadership, and tap into our collective 90+ year heritage. With combined FY15 revenues of approximately $5.5 billion and nearly 19,000 employees, CSRA represents the coming together - figuratively and literally - of two outstanding companies: the North American Public Sector business of CSC and SRA. Join us and watch your career take flight. The Pharmacy Technician performs reviews of prior approval requests submitted by enrolled providers. Escalates problems to appropriate personnel when needed.
Responsibilities
* Answers incoming provider calls regarding prior approval request processing. * Documents prior approval requests and associated history. * Evaluates available information to validate prior approval requests. * Verifies policyholder information, policy effective dates, premium status and verification of prior approval request eligibility. * Sends prior approval request form to provider for updating, correction or completion. * Investigates simple to moderately complex prior approval request and determines level or resolution if appropriate; advises provider of status; assists in negotiating settlement and resolution of prior approval request. * Identifies need for additional information; contacts appropriate source to obtain needed information. * Performs review of prior approval requests for pharmacy program.
Ideal Candidate
**Basic Qualifications** * High school diploma or G.E.D. * Fellowship of Life Health Claims (FLHC) Certification preferred * Two or more years of auditing, accounting, contracts or information technology experience * Experience working with insurance and/or medical terminology * Experience working with appropriate claims processing procedures and documentation **Other Qualifications** * Performing under North Carolina's approved criteria that outlines policies and requirements, this position determines prior approval for specific procedures * Certified Pharmacy Technician (CPHT) * Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods of close vision looking at a computer monitor * Excellent phone skills * Excellent customer service skills and professional tone and demeanor

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