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Description SHIFT: Day JobSCHEDULE: Full-timeYour Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company.Pharmacy Technician I: PTCB Certified: Bilingual Spanish:No UM approval or denial activities will be performed.Responsible for the interpretation and data entry of basic prescriptions, prior authorization processing, and troubleshooting adjudication issues.Primary duties may include, but not limited to:Verifies member information and inputs data for the pharmacists.Educates members on pharmacy based rules related to prescriptions and medication resources or assistance programs.Processes prior authorization requests from physicians offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations.Provides resolution to grievances and appeals issues.Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports.Maintains record keeping of prior authorizations, rebates, and monthly reports.Requires a high school diploma; Bilingual Spanish: PTCB Certification: 1 year of pharmacy experience; or any combination of education and experience, which would provide an equivalent background. Current State Pharmacy Tech. Certification or National Certification based on applicable state(s) required.For URAC accredited areas the following applies: Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.Qualifications Requires High School diploma and up to 1 year of pharmacy experience, or any combination of education and experience, which would provide an equivalent background. Must be bilingual / fluent in Spanish. Must have PTCB Certification. State Tech-in-Training certificate may be required in applicable state(s). Basic computer and written, oral and interpersonal communications skills required.REQNUMBER: PS43310
