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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].