Customer Service Rep/Pharmacy (Nice Change from Retail!)

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.

Prescription Solutions is the pharmacy and medical management unit of PacifiCare Health Systems, which is now part of a UnitedHealth Group company. We are expanding on the success of innovative benefit programs designed to improve outcomes and control costs. Join us for that rare combination of realizing outstanding career potential with a healthy business that is focused on improving the lives of others.





We're seeking a registered Pharmacy Technician to handle a wide variety of duties in our pharmacy/prior authorization department. This Customer Service Representative role offers a set schedule, a supportive team environment, and excellent benefits. If you are ready to bring your pharmacy expertise to a Fortune 100 organization, apply now!





Primary responsibilities include:


Processing phoned-in and written requests for prior authorization from physicians and their designated agents
Establishing the appropriateness of requests based on benefits and policies and guidelines
Evaluating prior authorization requests to determine what benefit is billed if approved
Coordinating routine, complex, and/or escalated prior authorization issues with the internal pharmacist team to facilitate clinical decisions of prior authorization requests
Answering incoming calls to assist customers/pharmacies/physicians with orders and reorders, benefit eligibility, general customer service questions and prior authorization/prescription status inquiries
Assisting pharmacies and members on specific questions about the processing of pharmacy claims related to prior authorization
Determining the appropriateness of overriding pharmacy claims edits and error messages
Making outbound calls to obtain prescriptions
Educating internal and external customers on benefits, use of plan, formulary, premiums, and status of orders, claims or inquiries


Job Requirements:

Only candidates who are registered as Pharmacy Technicians in the state of California will be considered. National Pharmacy Technician certification is preferred. Solid experience providing customer service and working with benefit eligibility and claims or prior authorizations within a pharmacy environment is also preferred. Good computer and typing skills will be needed. An Associate's degree is preferred. Applicants must be able to work 8-hour shifts five days a week. New Pharm Tech graduates who are registered in CA are encouraged to apply!





UnitedHealth Group offers a full range of comprehensive benefits, including medical, dental and vision, as well as a matching 401k and an employee stock purchase plan.



If you are interested in growing professionally within an innovative, highly respected organization, we invite you to explore this excellent growth opportunity!



Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V.