"Alerted.org

Duration: 06 months contract

Duties

+ This is a high-volume inbound call role responsible for providing professional and courteous assistance to members, providers, and other healthcare professionals. The role focuses on supporting the criteria-based prior authorization process by reviewing clinical information and ensuring accurate documentation of all determinations...

+ Handle incoming calls from members, providers, and other healthcare professionals.

+ Deliver exceptional customer service while guiding callers through the prior authorization process.

+ Review clinical documentation to determine completeness and eligibility based on established criteria.

+ Accurately document all approvals and denials in a timely manner.

+ Escalate complex inquiries and clinical judgment calls to the pharmacist for further evaluation.

+ Maintain compliance with regulatory requirements and internal protocols.

Required Experience & Qualifications:

+ Minimum 1 year of experience as a pharmacy technician or comparable healthcare role in a high-volume call center environment.

+ National Pharmacy Certification or State License preferred.

+ Eligible for state registration, certification, or licensure as preferred.

+ Strong computer skills, including proficiency in word processing and spreadsheets.

+ Excellent verbal and written communication skills.

Education:

+ High School diploma or GED required.

+ National Pharmacy Certification or State License in good standing preferred.

About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com) .

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity,

national origin, disability, or status as a protected veteran