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Ventegra

Job PurposeVentegra is a rapidly growing, fast paced, innovative virtual company. As part of Ventegra, the Pharmacy Technician I, provide daily operational support to the Pharmacist and Customer Care Specialist related to prior authorizations. The Pharmacy Technician 1 has the clinical skills to review and evaluate the appropriateness and medical necessity of medications based on established criteria. The Pharmacy Technician I, promotes and supports quality pharmacy services.Duties and Responsibilities<ul><li>Maintain an accurate and current knowledge of required criteria, training materials, systems, prior authorization processes and plan benefits</li><li>Accurately enter authorizations approvals in the claims processing system</li><li>Accurately document case notes relate to member&rsquo;s medications as required in the prior authorization review process</li><li>Review incoming fax requests for medications requiring a prior authorization, while ensuring an elevated level of customer service and maximizing productivity. Requests additional information from providers as needed to properly evaluate the request</li><li>Assist Clinical Pharmacist by providing accurate documentation and clear clinical notes related to a prior authorization request</li><li>Provide clinical review and determinations of prior authorization in keeping with legal and contractual requirements, including turnaround times and service level agreements</li><li>Escalate issues through the appropriate channel of management to ensure patient has access to medications</li><li>Effectively manages and prioritize prior authorization requests based on turn-around times</li><li>Effectively communicates both internally and externally to enhance the effectiveness of pharmacy prior authorization process and ensure the needs of the members and clients are met</li><li>Must maintain the highest level of member confidentiality and adheres to all company policies regarding confidentiality and HIPAA</li><li>Assist in the processing of telephonic prior authorizations request from physicians using established criteria and guideline</li><li>Assist with other duties and responsible as assign by management based on department needs</li></ul>Required Skills and Abilities<ul><li>Excellent verbal and written communication skills</li><li>Ability to focus and prioritize</li><li>Accurate and detail oriented</li><li>Ability to multi-task with minimal direction</li><li>Flexibility and ability to adapt to changes and updates to processes and protocols</li><li>Demonstrate problem-solving skills, information gathering, research, alternatives analysis, applying creative solutions to unique and/or immediate issues</li><li>High volume call center experience a plus</li><li>Experience processing in pharmacy prior authorization request using medication criteria</li><li>Proficient in Microsoft Office programs (Word, Excel, Outlook, etc.)</li><li>Dependability and good attendance are an essential function of the job</li></ul>Education and Experience<ul><li>High School Diploma or GED equivalent.</li><li>Current Pharmacy Technician License required; Certified Pharmacy Technician License (CPhT) required</li><li>1-year experience as a Pharmacy Prior Authorization Technician or minimum 1-year experience as a Ventegra Customer Care Specialist (CCS) with Technician Certification (CPhT required)</li><li>1-year experience as a Pharmacy Benefit Management(PBM) Prior Authorization Technician preferred</li></ul>Work environment requirementsA home office setting, free from noise and distraction allowing you to interact professionally both externally and internally.Pay: $20.00 per hourApplication Question(s):<ul><li>Do you have a valid PTCB or NHA pharmacy technican certification? </li><li>Are you available to work any time from 6:00am PST to 7:00pm PST?</li><li>Do you have Pharmacy Benefit Management(PBM) experience? If yes, how many years?</li></ul>Work Location: Remote

Clinical Pharmacy Technician I | Prior Authorization

Job PurposeVentegra is a fast paced, innovative virtual company. A Pharmacy Intake Coordinator provides daily operational support within the Prior Authorization department. They are an essential part of the team that assists in providing excellent service to our clients and members. A Pharmacy Intake Coordinator performs all assigned tasks accurately, efficiently, and per the applicable policies and procedures.Duties and Responsibilities<ul><li>Review prior authorization faxes requested from physicians and triage within the prior authorization dashboard</li><li>Perform non-medical research, including eligibility verification, COB, and benefits verification.</li><li>Maintains accurate and complete documentation (ie, notes) of required information using templates that meets risk management, regulatory, and accreditation requirements.</li><li>Update additional documentation received in prior authorization cases and change status to the next process</li><li>Log on to the phone system during all scheduled shifts.</li><li>Make outbound calls to verify fax numbers and other information related to prior authorization requests.</li><li>Send prior authorization requests via email to specific groups and plans based on internal processes</li><li>Fax prior authorization documentation to physicians and pharmacies</li><li>Notify physicians and pharmacies of prior authorization determinations as needed</li><li>Maintain a working knowledge of all departmental policies, processes, updates, and resources</li><li>May provide backup support to other operations within the department, based on business needs.</li><li>Work in collaboration with the Prior Authorization team to meet department goals and regulatory requirements for turnaround times</li><li>Attend department staff and other meetings as requested</li><li>Review and implement all updated or new information discussed during staff meetings, provided by email, team chats, or other communications from leadership</li><li>Complete annual compliance training (ie, security, HIPAA, etc)</li><li>Protect the confidentiality of member information and adhere to all company policies regarding confidentiality and HIPAA</li><li>Meet individual metrics set by department leadership</li><li>Other duties as assigned by department leadership based on department needs</li></ul>Required Skills and Abilities<ul><li>Good verbal and written communication skills</li><li>Good interpersonal and organizational skills</li><li>Flexibility and ability to quickly adapt to changes and updates in processes and protocols</li><li>Demonstrated problem-solving skills when gathering and researching information</li><li>Ability to focus on tasks through completion with repetition</li><li>Strong prioritization skills</li><li>Strong attention to detail with consistent accuracy</li><li>Ability to work independently yet cohesively within a team to achieve results</li><li>Dependability and good attendance are an essential function of a Pharmacy Intake Coordinator</li><li>Strong ability to multi-task, including but not limited to working in multiple software systems simultaneously</li><li>Proficiency in Microsoft Office applications (ie, Teams, Outlook, Word, and Excel, etc).</li></ul>Education and Experience<ul><li>High School Diploma</li><li>Healthcare and pharmacy experience a plus</li><li>Pharmacy Technician state license preferred</li></ul>Work environment requirementsA home office setting, free from noise and distraction allowing you to interact professionally both externally and internallyPay: $15.00 per hourApplication Question(s):<ul><li>Do you have valid Pharmacy Technician License? </li></ul>Work Location: Remote

Pharmacy Intake Coordinator

Job PurposeVentegra is a rapidly growing, fast paced, innovative virtual company. As part of Ventegra, the Pharmacy Technician I, provide daily operational support to the Pharmacist and Customer Care Specialist related to prior authorizations. The Pharmacy Technician 1 has the clinical skills to review and evaluate the appropriateness and medical necessity of medications based on established criteria. The Pharmacy Technician I, promotes and supports quality pharmacy services.Duties and Responsibilities<ul><li>Maintain an accurate and current knowledge of required criteria, training materials, systems, prior authorization processes and plan benefits</li><li>Accurately enter authorizations approvals in the claims processing system</li><li>Accurately document case notes relate to member&rsquo;s medications as required in the prior authorization review process</li><li>Review incoming fax requests for medications requiring a prior authorization, while ensuring an elevated level of customer service and maximizing productivity. Requests additional information from providers as needed to properly evaluate the request</li><li>Assist Clinical Pharmacist by providing accurate documentation and clear clinical notes related to a prior authorization request</li><li>Provide clinical review and determinations of prior authorization in keeping with legal and contractual requirements, including turnaround times and service level agreements</li><li>Escalate issues through the appropriate channel of management to ensure patient has access to medications</li><li>Effectively manages and prioritize prior authorization requests based on turn-around times</li><li>Effectively communicates both internally and externally to enhance the effectiveness of pharmacy prior authorization process and ensure the needs of the members and clients are met</li><li>Must maintain the highest level of member confidentiality and adheres to all company policies regarding confidentiality and HIPAA</li><li>Assist in the processing of telephonic prior authorizations request from physicians using established criteria and guideline</li><li>Assist with other duties and responsible as assign by management based on department needs</li></ul>Required Skills and Abilities<ul><li>Excellent verbal and written communication skills</li><li>Ability to focus and prioritize</li><li>Accurate and detail oriented</li><li>Ability to multi-task with minimal direction</li><li>Flexibility and ability to adapt to changes and updates to processes and protocols</li><li>Demonstrate problem-solving skills, information gathering, research, alternatives analysis, applying creative solutions to unique and/or immediate issues</li><li>High volume call center experience a plus</li><li>Experience processing in pharmacy prior authorization request using medication criteria</li><li>Proficient in Microsoft Office programs (Word, Excel, Outlook, etc.)</li><li>Dependability and good attendance are an essential function of the job</li></ul>Education and Experience<ul><li>High School Diploma or GED equivalent.</li><li>Current Pharmacy Technician License required; Certified Pharmacy Technician License (CPhT) required</li><li>1-year experience as a Pharmacy Prior Authorization Technician or minimum 1-year experience as a Ventegra Customer Care Specialist (CCS) with Technician Certification (CPhT required)</li></ul>Work environment requirementsA home office setting, free from noise and distraction allowing you to interact professionally both externally and internally.Pay: $20.00 per hourWork Location: Remote

Clinical Pharmacy Technician I

Join Ventegra and explore 3   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

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Clinical Pharmacy Technician I | Prior Authorization

Pharmacy Intake Coordinator

Clinical Pharmacy Technician I