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Tech Pharmacy Health Plan - Hybrid
Tech Pharmacy Health Plan - Hybrid-November 2024
Nashville
Nov 17, 2024
About Tech Pharmacy Health Plan - Hybrid

  Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.

  Job Posting Title

  Tech Pharmacy Health Plan - Hybrid

  Job Description

  The Pharmacy Technician Health Plan is responsible for working with the Paper Claims staff to identify equivalent U.S. product information for the handling of foreign claims. This role is responsible for providing National Drug Code (NDC), National Provider Identifier (NPI), and National Association of Boards of Pharmacy (NABP) numbers, quantities, and/or day supply information needed for manual claims processing.

  This role will have a rotation that will require this person to be in the Eagan, MN office on a rotational basis (every 5th Thursday for 4 hours).

  Responsibilities

  Research, select, and document equivalent U.S. drug product for processing of foreign paper claims

  Create and maintain current foreign and compound claims processing policies and procedures

  Maintain and research correct drug information for processing vendor and provide appropriate NDC, NPI and NABP numbers, quantities, and day supply information for manual claims processing

  Contact pharmacies to verify members’ claim information

  Review various claims reports and partner cross functionally on research and issue resolution

  Process exception claims to meet client performance guarantees

  Other duties as assigned

  Minimum Qualifications

  High school diploma from an accredited school or equivalent GED

  2 years of work experience in the retail or hospital industry

  Current registration with State Board of Pharmacy in the State where the position is located

  National Pharmacy Technician Certification through PTCB or ExCPT (CPhT)

  Must be eligible to work in the United States without need for work visa or residency sponsorship

  Additional Qualifications

  Strong verbal and written communication skills

  Ability to manage multiple priorities simultaneously

  Proven knowledge of drugs for drug categorization

  Preferred Qualifications

  Understanding of point of sale, online pharmacy claims processing environment

  Previous work experience in the PBM or managed care industry

  Minimum Physical Job Requirements

  Ability to work a flexible schedule including weekends, holidays, overtime, on call, and shifts outside of Prime’s core business hours of 9:00 a.m. to 3:00 p.m.

  Ability to spend at least 25% of work day on telephone contacting pharmacies

  Constantly required to sit, use hands to handle or feel, talk and hear

  Frequently required to reach with hands and arms

  Occasionally required to stand, walk and stoop, kneel, and crouch

  Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds

  Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus

  Reporting Structure

  Reports to a Supervisor in the PBM Operations departmentPotential pay for this position ranges from $19.23 - $24.90 based on experience and skills. Pay range may vary by 8% depending on applicant location.

  To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/careers/benefits/) and click on the "Benefits at a glance" button for more detail.

  Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law.

  Positions will be posted for a minimum of five consecutive workdays.

  Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.

  If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.

  Prime Therapeutics LLC is an Equal Opportunity Employer. We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. ​ If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email [email protected].

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