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