Pharmacy Call Center Technician

Type of Requisition:

Regular

Clearance Level Must Currently Possess:

None

Clearance Level Must Be Able to Obtain:

None

Suitability:

No Suitability Required

Public Trust/Other Required:

Job Family:

Customer Service

Job Description:

Responsibilities:

• Performing under North Carolina's approved criteria that outlines policies and requirements this position determines prior approval for medications.
• Answers incoming provider calls regarding prior approval request processing, claims processing, and lock-in questions. Documents prior approval requests and associated history.
• Evaluates available information to validate prior approval requests. Verifies policyholder information, policy effective dates, premium status, and verification of prior approval request eligibility.
• Investigates simple to moderately complex prior approval requests and determines level or resolution if appropriate; advises provider of status; assists in negotiating settlement and resolution of prior approval request.
• Identifies need for additional information; contacts appropriate source to obtain needed information. 
• Performs review of prior approval requests and pharmacy claims for the pharmacy program. 
• Other duties as assigned

Basic Qualifications

• High school diploma or equivalent
• Minimum of one-year pharmacy experience
• Basic computer skills including dual-screen use, copy + paste, and accurate typing at speed of at least 45 WPM
• Ability to pass a criminal background check, drug screening
• Must be a US Citizen
• Availability to work any shift during hours of operation: Monday-Friday 7 am to 11 pm and Saturday and Sunday 7 am to 6 pm.

Preferred Qualifications

• CPhT through PTCB

Scheduled Weekly Hours:

40

Travel Required:

None

Telecommuting Options:

Hybrid

Work Location:

USA NC Raleigh

Additional Work Locations:

COVID-19 Vaccination: GDIT does not have a vaccination mandate applicable to all employees. To protect the health and safety of its employees and to comply with customer requirements, however, GDIT may require employees in certain positions to be fully vaccinated against COVID-19. Vaccination requirements will depend on the status of the federal contractor mandate and customer site requirements.We are GDIT. The people supporting some of the most complex government, defense, and intelligence projects across the country. We deliver. Bringing the expertise needed to understand and advance critical missions. We transform. Shifting the ways clients invest in, integrate, and innovate technology solutions. We ensure today is safe and tomorrow is smarter. We are there. On the ground, beside our clients, in the lab, and everywhere in between. Offering the technology transformations, strategy, and mission services needed to get the job done.GDIT is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other protected class.