Pay rate is 15.50Training is for 2 weeks. Training time is 8:00am-4:30pm CST. Monday- Friday. Description/Job Duties:- Indexing agent : data entry; they are grabbing the fax images that are received from their providers and are looking for specific information; don't need to read everything but needs to be able to identify the members information, provider, medication they are requesting, any sense of urgency- Some type of pharmacy background- Entering drug information, identifying syringe, capsule, tablet- Outbound calls: dual trained position, if there is no work for the day will be trained in outbound calls to make phone calls but ideally they won't really use them to do the calls; might be anhour once per month; would be calling out to let them know the results of the prior authorization if it was approved or denied; just on the drug piece- Have metrics per day and per hour: set them up with a glide path which is 8 weeks so slowly; in total 30 cases per hour; training is 2.5 weeks and then glid Primary Responsibilities:Sort electronic copies of incoming fax transmittals and index them into the appropriate Prior Authorization System PAS workbasketsResearch and identifying member provider and drug information across multiple computer systemsReview Incoming PA faxes and initiate coverage determination requests in a timely manner within SLAPerform outbound calls to Providers and/or Members to obtain additional information to resolve Prior Authorization cases. Perform outbound call to Providers and/or to inform them of the outcome of Prior Authorization cases. Additional Responsibilities:Navigate across multiple computer systems to identify information needed for outbound calls to members/providers.Make outgoing calls as needed to provide information on prior authorization case outcome follow-up or consultation such as prior authorization requirements appeals etc.Educate members / guardians providers pharmacy staff on procedures to avoid compliance risk.Meet departmental established performance expectations and working independently to complete tasks in a timely manner.May include processing member prior authorizations through various computer systems ensuring the accuracy of all data and updating as necessary.May take incoming calls from members or providers and apply benefit plan criteria in making decisions approvals / denials or recommendations clarify and explain pharmaceutical benefits and procedures.May partner with others to gather additional information and / or to interpret clinical guidelines act as a resource for othersIncumbents typically are not licensed pharmacy technicians.May include licensed pharmacy technicians doing non-technician work*Training is for 2 weeks. Training time is 8:00am-5:00pm CST. Monday- Friday. This training time is subject to change*Candidate will work 5 days a week which may or may not include a weekend days.*Candidate must have their own home internet access/VPN internet can be hard wired with Ethernet cord

Training, Procedures, Research, Review, Inbound Outbound Calls, About Time, Internet, Benefit Functions, Hiring Processes, Communication Skills, Clinical Trial Operations, Attendance, Computer System, Distribute Faxes, Appeals, Pharmacy, PC OS, Offshore, Service Level Agreements, VPN Technologies, Consultation, Denials, Overtime, Fax, Language Interpretation

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Eden Prairie, MN
remote
Temporary
15.50 - 15.50 USD / Hourly
Pay rate is 15.50Training is for 2 weeks. Training time is 8:00am-4:30pm CST. Monday- Friday. Description/Job Duties:- Indexing agent : data entry; they are grabbing the fax images that are received from their providers and are looking for specific information; don't need to read everything but needs to be able to identify the members information, provider, medication they are requesting, any sense of urgency- Some type of pharmacy background- Entering drug information, identifying syringe, capsule, tablet- Outbound calls: dual trained position, if there is no work for the day will be trained in outbound calls to make phone calls but ideally they won't really use them to do the calls; might be anhour once per month; would be calling out to let them know the results of the prior authorization if it was approved or denied; just on the drug piece- Have metrics per day and per hour: set them up with a glide path which is 8 weeks so slowly; in total 30 cases per hour; training is 2.5 weeks and then glid Primary Responsibilities:Sort electronic copies of incoming fax transmittals and index them into the appropriate Prior Authorization System PAS workbasketsResearch and identifying member provider and drug information across multiple computer systemsReview Incoming PA faxes and initiate coverage determination requests in a timely manner within SLAPerform outbound calls to Providers and/or Members to obtain additional information to resolve Prior Authorization cases. Perform outbound call to Providers and/or to inform them of the outcome of Prior Authorization cases. Additional Responsibilities:Navigate across multiple computer systems to identify information needed for outbound calls to members/providers.Make outgoing calls as needed to provide information on prior authorization case outcome follow-up or consultation such as prior authorization requirements appeals etc.Educate members / guardians providers pharmacy staff on procedures to avoid compliance risk.Meet departmental established performance expectations and working independently to complete tasks in a timely manner.May include processing member prior authorizations through various computer systems ensuring the accuracy of all data and updating as necessary.May take incoming calls from members or providers and apply benefit plan criteria in making decisions approvals / denials or recommendations clarify and explain pharmaceutical benefits and procedures.May partner with others to gather additional information and / or to interpret clinical guidelines act as a resource for othersIncumbents typically are not licensed pharmacy technicians.May include licensed pharmacy technicians doing non-technician work*Training is for 2 weeks. Training time is 8:00am-5:00pm CST. Monday- Friday. This training time is subject to change*Candidate will work 5 days a week which may or may not include a weekend days.*Candidate must have their own home internet access/VPN internet can be hard wired with Ethernet cord
2025-09-23T14:13:54Z

Remote Associate Pharmacy Clerk Job in Eden Prairie | Robert Half