Clinical Pharmacy Technician
Aguadilla, Puerto Rico
Job type Full Time (Onsite)
This position supports the corporate pharmacists. Coordinates and administers the effective and efficient processing of the pharmacy benefits prior authorization process, ensuring that pharmacy benefits are administered in accordance with all regulatory agency requirements.
Principal Duties and Responsibilities:
- Reviews pharmacy utilization management (UM) coverage requests and prepares such cases for clinical review by a pharmacist and/or medical director when required
- Within the context of the request, applies plan-specific benefits to each case appropriately, summarizes pertinent facts, and cites applicable internal policies and guidelines
- Resolves non-clinical issues independently and acts as a liaison between our customer and provider-facing teams and the Corporate Pharmacy Department
- Maintain regulatory compliance and resolves all cases within predetermined timeframes
- Responsible for all preauthorization entries into applicable databases (i.e. internal medical claims systems, PBM pharmacy systems) to ensure swift and appropriate payment of services deemed medically necessary
- • Engages in member and provider outreach to resolve non-clinical issues such as appeal initiation requests, processing errors, and fulfilling notification requirements among others
- May perform other non-clinical duties as required by management and department needs
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Basic:
- High School Diploma or GED Equivalent
- 1 year of experience as a Pharmacy Technician in a hospital, retail, or managed care setting
- Must have Certified Pharmacy Technician License (CPhT)
- Strong knowledge of medical and pharmaceutical terminology
- Strong verbal and written communication skills
- Well organized, paying close attention to detail
- Ability to identify and resolve problems
- Ability to handle multiple priorities in a timely manner
- Strong interpersonal skills
- Ability to work independently or in a team environment
- Customer oriented
- Proficient with Microsoft Office products (i.e. Word, Excel, Powerpoint, etc.)
Infosys BPM Limited, a wholly owned subsidiary of Infosys Limited (NYSE: INFY), provides end-to-end transformative business process management (BPM) services for its clients across the globe. The company's integrated IT and BPM solutions approach enables it to unlock business value across industries and service lines, and address business challenges for its clients. Utilizing innovative business excellence frameworks, ongoing productivity improvements, process reengineering , automation , and cutting-edge technology platforms, Infosys BPM enables its clients to achieve their cost reduction objectives, improve process efficiencies, enhance effectiveness, and deliver superior customer experience.
Infosys BPM has 45 delivery centers in 16 countries spread across 5 continents, with 58,090 employees from 111 nationalities, as of June, 2024.
The company has been consistently ranked among the leading BPM companies globally and has received over 60 awards and recognitions in the last 5 years, from key industry bodies and associations like the Outsourcing Center, SSON, and GSA, among others. Infosys BPM also has very robust people practices, as substantiated by the various HR-specific awards it has won over the years. The company has consistently been ranked among the top employers of choice, on the basis of its industry leading HR best practices. The company's senior leaders contribute widely to industry forums as BPM strategists.
EOE/Minority/Female/Veteran/Disabled/Sexual Orientation/Gender Identity/National Origin
Infosys is an equal opportunity employer and all qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, spouse of protected veteran, or disability