Anthem, Inc. Pharmacy Tech I in Las Vegas, Nevada
SHIFT: Day Job
For Simply Healthcare and Americas First Choice Associates Only: No UM approval or denial activities will be performed.
Responsible for the interpretation and data entry of basic prescriptions, prior authorization processing, and troubleshooting adjudication issues.
Primary duties may include, but not limited to:
Verifies member information and inputs data for the pharmacists.
Educates members on pharmacy based rules related to prescriptions and medication resources or assistance programs.
Processes prior authorization requests from physicians offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations.
Provides resolution to grievances and appeals issues.
Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports.
Maintains record keeping of prior authorizations, rebates, and monthly reports.
Requires a high school diploma; 1 year of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
Current State Pharmacy Tech. Certification or National Certification based on applicable state(s) required.
For URAC accredited areas the following applies: Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.