Molina Healthcare logo
Molina Healthcare

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pharmacy Technician (Remote) Prior Auth

Medical Billing and CodingMedical Billing and CodingFull TimeRemoteMid LevelTeam 10,001

Location

United States

Posted

7 days ago

Salary

Not specified

Seniority

Mid Level

No structured requirement data.

Job Description

Molina Healthcare is hiring for remote Certified Pharmacy Technicians. These roles will be in our Prior Authorization department.  
You will review prior auth requests that are submitted.  
Schedules for these roles will be Mon through Fri 11am-7:30pm MST or 12:30pm-9pm MST.   The training schedule will be approximately 7 weeks 9am-5:30pm MST. 

Qualified candidates must have either PTCB certification or Pharmacy Tech State license. High preference for those who are self-starters and go-getters.  Must have above average computer skills along with a high level of communication skills both written and verbal.

As a Pharmacy Tech here at Molina, you will provide support for pharmacy technician activities. You will also contribute to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care.

Essential Job Duties

  • Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; requests additional information from providers as needed to properly evaluate requests.
  • Accurately enters approvals or denials of requests.
  • Facilitates prior authorization requests within established pharmacy policies and procedures.
  • Participates in the development/administration of pharmacy programs designed to enhance the utilization of targeted drugs and identification of cost-saving pharmacy practices.
  • Identifies and reports pharmacy departmental operational issues and resource needs to appropriate leadership.
  • Assists Molina member services, pharmacies, and health plan providers in resolving member prescription claims, prior authorizations, and pharmacy service access issues.
  • Articulates pharmacy management policies and procedures to pharmacy/health plan providers, Molina staff and others as needed.

Required Qualifications

  • At least 2 years pharmacy technician experience, or equivalent combination of relevant education and experience.
  • Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice.
  • Ability to abide by Molina policies.
  • Ability to maintain attendance to support required quality and quantity of work.
  • Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA).
  • Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.
  • Excellent verbal and written communication skills.
  • Microsoft Office suite (including Excel), and applicable software program(s) proficiency.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Related Categories

Related Job Pages

More Medical Billing and Coding Jobs

SelectQuote, Inc. logo

Pharmacy Billing Specialist

SelectQuote, Inc.

More than 35 years ago, SelectQuote was founded on one core promise: to help our customers protect the people they value most. We pioneered the way consumers shopped for term life insurance, and now, we also help people find home insurance, auto insurance, senior health insurance, and more. Our quick and easy process saves consumers both time and money, and today, more than 2 million families trust us to help them with their insurance needs. But what truly sets us apart is our people, and the opportunities to grow your career with SelectQuote are unmatched. SelectQuote Core Values Service: We create positive customer experiences. Entrepreneurship: We create innovate & take risks. Leadership: We build & invest in high-performing teams. Empowerment: We embrace a changing environment. Courage: We challenge the status quo & drive continuous improvement. Teamwork: We help support & celebrate each other.

Medical Billing and Coding7 days ago
Full TimeRemoteTeam 501-1,000

The Pharmacy Billing Specialist is responsible for collecting, posting, and managing patient account payments. The position is responsible for submitting patient claims to insurance companies and following up on claims with insurance companies. This position has no direct supervi...

United States
$18 - $21 / hour

Coding Claim Review Specialist (Inpatient and Outpatient)

CorroHealth

CorroHealth is a leader in clinically led healthcare analytics, offering solutions that streamline operations, enhance revenue integrity, and improve patient ca

Medical Billing and Coding7 days ago
Full TimeRemote

Assist the Director of HIM in preparing claim audits, reviewing, and recommending coding, revenue cycle, and charge/billing changes for hospital outpatient and Profee claims using proprietary software. Responsibilities also include developing reports, meeting with clients, responding to coding questions, and providing support to the revenue cycle consulting team.

United States
Highmark Health logo

Coder - Outpatient

Highmark Health

Creating remarkable health experiences, freeing people to be their best.

Medical Billing and Coding7 days ago
Full TimeRemoteTeam 10,001+Since 1852H1B Sponsor

This role involves performing thorough medical record reviews to abstract medical and demographic data, interpreting and applying diagnoses and procedures using ICD and CPT coding systems. Key duties include reviewing physician treatment plans to determine appropriate codes and abstracting data for statistical requests.

United States
$21 - $34 / hour
Forward Financing logo

Bilingual Collections Specialist

Forward Financing

Forward Financing is a financial technology company based in Boston, Massachusetts with team members throughout the United States, Dominican Republic, and Canada. The company is on a mission to unlock the capital that fuels small businesses across America. Forward has been recognized as a Best Place to Work by Built In and is certified as a Great Place To Work.® We’re investing in our employees, technology, and customer experience – with long-term success in mind every step of the way. Want to learn more? Visit: forwardfinancing.com/careers

Medical Billing and Coding7 days ago
Full TimeRemoteTeam 529Since 2012

As a Bilingual Account Specialist, you will manage SMB customer accounts affected by revenue fluctuations, establish payment plans, and provide empathetic service to recover dues.

Salesforce
United States
$28 - $31 / hour