Judi Health - Utilization Manager Appeals Technician (Temp to Hire)
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Requirements
• 1 + years’ experience working as a certified pharmacy technician in a managed care or PBM setting required. • Active, unrestricted certified pharmacist technician license required. • Excellent organization details and strong detail orientation. • Strong oral and written communication skills. • Ability to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven environment with shifting priorities. • Ability to work 12pm-9pm EST hours • Experience working with commercial and medicare appeals preferred • This range represents the low and high end of the anticipated base salary range. The actual base salary will depend on several factors such as: experience, knowledge, skills, and location of the job.
Responsibilities
• Follow all internal Standard Operating Procedures and adhere to HIPAA guidelines and policies. • Performs triple check to ensure quality reviews and handling in accordance with policies and procedures. • Updates case types, sends appeal acknowledgements, and submits case information to independent review organizations. • Communicate effectively with appeal pharmacists regarding internal and external appeals. • Make verbal outreach attempts to obtain necessary information for case review and record accurate information obtained on the call. • Exhibit excellent phone and communication skills while providing complete and accurate information to members and providers. • Performs all other related duties as assigned
Benefits
• $60,000—$65,000 USD • $78,800—$98,500 USD • $72,000—$90,000 USD • All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
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