Job Description
Please find below the details:
Position: Pharmacy Services Specialist
Location: Onsite – Orange, CA 92868
Duration: 6 months (Possibilities of extensions/conversion)
Shift: Day 5x8-Hour
Schedule : Monday to Friday, 8:00 a.m. – 5:00 p.m.
Position Summary:
We are seeking a Pharmacy Technician for a full-time temporary role supporting Medicare Part D beneficiaries. This position will focus on pharmacy-related program support, case management, and assisting network pharmacies and providers with claims, billing, and authorization processes.
Key Responsibilities:
- Manage caseloads to ensure resolution of member and pharmacy cases within department standards.
- Assist with drug-specific technical data retrieval and pharmacy operations.
- Support network pharmacies and prescribers with billing, claims processing, eligibility, and authorization issues.
- Resolve pharmacy claims disputes involving various departments and external entities.
- Interpret and communicate Pharmacy program policies and procedures to providers and staff.
- Process pharmaceutical prior authorization and appeals requests per guidelines.
- Coordinate pharmacy services with internal teams and external providers.
- Handle pharmacy-related member complaints and assist in resolving prior authorization requests.
- Complete other assigned projects and duties.
Minimum Qualifications:
- High School Diploma or equivalent.
- 1+ year of Pharmacy Technician experience in ambulatory, community, home infusion, long-term care, or managed care settings.
- Completion of an accredited Pharmacy Technician training program.
- Active Pharmacy Technician registration with the California Board of Pharmacy.
Preferred Qualifications:
- Associate’s degree in a health-related field.
- Pharmacy Technician Certification Board (PTCB) certification.
- Bilingual in English and one of the defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese).
Skills & Abilities:
- Strong relationship-building skills with internal teams and external contacts.
- Excellent verbal and written communication abilities.
- Ability to work independently, exercise sound judgment, and manage multiple projects in a fast-paced environment.
- Proficiency in Microsoft Office Suite (Word, Outlook, Excel, PowerPoint) and job-specific applications.
Job Tags
Full time, Temporary work, Work at office, Monday to Friday, Shift work,