Imperial Management Administrators Services
Active Certified Pharmacy Technician
Responsible for researching and supporting the clinical and operational processes for Medicare and Medi-Cal members. This includes reviewing requests for Part B medications for medically necessity, reaching out to provider offices for additional information and working closing with an pharmacists
ESSENTIAL JOB FUNCTIONS:
1. Process prior authorization requests per state and federal timeliness standards
Perform analysis, obtain information, and enter prior authorization data necessary for claims adjudication.
Utilizes authorization matrix, DOFR and/or delegation agreements for decision-making
4. Coordinates with Clinical Pharmacist and/or Medical Director to facilitate medical necessity reviews.
5. Outreach to provider offices when additional information is needed.
6. Interact with our customers to provide and obtain information and ensure the delivery of outstanding service and quality.Work with support, relying on instructions, work process guidelines and procedures, and company experience to perform the responsibilities of the job.
· High school graduate or equivalent.
· 1+ year prior authorization experience preferred.
· 1+ Health plan or CMS experience preferred.
· Experience with Medicare Part ‘B” preferred
· Proficiency with Microsoft Office Suite: Word, Excel, Outlook and Power Point
To apply for this job please visit forms.office.com.