We are looking for a detail-oriented Pharmacy Clerk to join our team in Eden Prairie, Minnesota. This long-term contract position involves supporting insurance authorization processes, including managing prior authorization requests and conducting outreach to healthcare providers and members. The role requires strong organizational skills, effective communication, and the ability to work across multiple systems to ensure timely and accurate processing. Responsibilities: • Organize and index electronic copies of fax transmittals into the appropriate prior authorization system workbaskets. • Research and verify member, provider, and drug details using multiple computer systems. • Review incoming prior authorization faxes and initiate coverage determination requests promptly. • Conduct outbound calls to providers or members to gather additional information needed for case resolution. • Inform providers of prior authorization case outcomes and provide guidance on compliance procedures. • Navigate multiple computer systems to retrieve and utilize data during calls and case processing. • Process member prior authorizations, ensuring accuracy and updating information as required. • Handle incoming calls from members or providers, applying benefit plan criteria to make decisions or clarify benefits. • Educate stakeholders on pharmaceutical benefits, appeals, and prior authorization requirements. • Meet performance expectations and complete tasks independently in a timely manner.

• High proficiency in using a PC, including navigating multiple systems and screens. • Strong communication skills, both written and verbal, to interact effectively with members and providers. • Ability to work independently and meet departmental performance goals. • Experience in researching and analyzing data across various computer systems. • Familiarity with insurance authorization processes and procedures. • Reliable high-speed internet connection with Ethernet capability for remote work. • Secure, distraction-free home office setup to maintain productivity during work hours. • Availability for scheduled overtime, holidays, and flexible shifts, including weekends as needed.

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Eden Prairie, MN
remote
Temporary
15.00 - 15.50 USD / Hourly
We are looking for a detail-oriented Pharmacy Clerk to join our team in Eden Prairie, Minnesota. This long-term contract position involves supporting insurance authorization processes, including managing prior authorization requests and conducting outreach to healthcare providers and members. The role requires strong organizational skills, effective communication, and the ability to work across multiple systems to ensure timely and accurate processing. Responsibilities: • Organize and index electronic copies of fax transmittals into the appropriate prior authorization system workbaskets. • Research and verify member, provider, and drug details using multiple computer systems. • Review incoming prior authorization faxes and initiate coverage determination requests promptly. • Conduct outbound calls to providers or members to gather additional information needed for case resolution. • Inform providers of prior authorization case outcomes and provide guidance on compliance procedures. • Navigate multiple computer systems to retrieve and utilize data during calls and case processing. • Process member prior authorizations, ensuring accuracy and updating information as required. • Handle incoming calls from members or providers, applying benefit plan criteria to make decisions or clarify benefits. • Educate stakeholders on pharmaceutical benefits, appeals, and prior authorization requirements. • Meet performance expectations and complete tasks independently in a timely manner.
2025-08-25T14:49:31Z

Pharmacy Clerk Job in Eden Prairie | Robert Half