Pharmacy Technician (PTCB)

Job Description:

• Track and triage coverage determination requests submitted from providers and determine if a pharmacist review is required

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Obtain verbal authorizations and request detailed clinical information from prescribers

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Approve coverage determination requests based on defined criteria

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Enter and document coverage determination request decision into the PBM system and notify providers and/or members

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Respond to client inquiries regarding authorization approvals and PBM on-line applications

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Refer coverage determination requests for specialty drugs to delegated vendor or client for processing

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Contact providers for additional information to facilitate coverage determination reviews

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Notify physicians, providers and members of coverage determination request decisions