Job Description

Public Trust: None

Requisition Type: Regular

Your Impact

Own your opportunity to work alongside federal civilian agencies. Make an impact by providing services that help the government ensure the well being of U.S. citizens.

Job Description

We are hiring for the following shifts:

5pm-10pm

Summary:

The Pharmacy Call Center Technician is responsible for providing knowledgeable and courteous customer assistance and response to beneficiaries, providers, and pharmacies. The Pharmacy Call Center Technician also performs reviews of prior approval requests submitted by enrolled providers.

Responsibilities:

• Performing under North Carolina's approved criteria that outlines policies and requirements this position determines prior approval for medications.
• Answers incoming provider calls regarding prior approval request processing, claims processing, and lock-in questions. Documents prior approval requests and associated history.
• Evaluates available information to validate prior approval requests. Verifies policyholder information, policy effective dates, premium status, and verification of prior approval request eligibility.
• Investigates simple to moderately complex prior approval requests and determines level or resolution if appropriate; advises provider of status; assists in negotiating settlement and resolution of prior approval request.
• Identifies need for additional information; contacts appropriate source to obtain needed information. 
• Performs review of prior approval requests and pharmacy claims for the pharmacy program. 
• Other duties as assigned

Basic Qualifications

• High school diploma or equivalent
• Minimum of one-year pharmacy experience
• Basic computer skills including dual-screen use, copy + paste, and accurate typing at speed of at least 45 WPM
• Ability to pass a criminal background check, drug screening
• Must be a US Citizen
• Availability to work any shift during hours of operation

Preferred Qualifications

• CPhT through PTCB

GDIT IS YOUR PLACE:

• Full-flex work week to own your priorities at work and at home
• 401K with company match
• Comprehensive health and wellness packages
• Internal mobility team dedicated to helping you own your career
• Professional growth opportunities including paid education and certifications
• Cutting-edge technology you can learn from
• Rest and recharge with paid vacation and holidays

Work Requirements

Years of Experience

1 + years of related experience

* may vary based on technical training, certification(s), or degree

Certification

Travel Required

None

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