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documentation customer service pharmacy operations prior authorization cphtπ Description
- Process prior authorization requests and support escalated PA issues.
- Use Oscar and vendor tools to determine eligibility and track PA requests.
- Collect medical information via phone, fax, and portal; document decisions.
- Meet required PA decision timeframes and escalate when needed.
- Communicate PA outcomes accurately and in compliance with standards.
- Ensure compliance with applicable laws and regulations.
π― Requirements
- 2+ years pharmacy-related experience in retail or managed care and/or PA.
- Active, unrestricted CPhT certification.
- Excellent customer service, phone etiquette, and typing skills.
π Benefits
- Medical, dental, and vision benefits.
- 11 paid holidays, paid sick time, and paid parental leave.
- 401(k) plan participation with company match; life and disability insurance.
- 15 days of vacation per year.
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