Pharmacy PA/Appeals Technician

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life’s best work.SM

Schedule: 8:00am to 5:00pm EST Monday-Friday and there will be on call responsibilities from 5:00 pm to 8:00pm Monday-Friday, Saturday, Sunday, and Holidays from 8:00 am to 8:00 pm (this on call schedule will rotate as well).

If you reside in Maine, you will enjoy the flexibility of a hybrid remote role as you take on some tough challenges.

Primary Responsibilities:  

• Provide pharmacy claims and prior authorization support for customer inquiries received via the telephone and/or Internet. Customers include physician's offices, pharmacies, and patients/caregivers
• The pharmacy technician must be able to assess the nature of the pharmacy claim issue or pharmacy related question and resolve claims adjudication problems while being professional, courteous, and efficient
• The technician must work together with pharmacists and account management team to gain understanding of the State of Maine Medicaid Preferred Drug List
• Must be able to multi-task using multiple applications to provide accurate and responsive information to the provider inquiry
• Knowledge of medications and pharmacy claims processing is required. Training will be provided
• Must be proficient at time management and be able to work independently and collaboratively as part of a team

What are the reasons to consider working for UnitedHealth Group?   Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
• More information can be downloaded at: 
  http://uhg.hr/uhgbenefits

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:  

• High School Diploma / GED (or higher)
• Active and unrestricted Pharmacy Technician license in the state of Maine OR National Pharmacy Technician Certification (PTCB) OR the ability to obtain either license within 6 months of hire date 
• 1+ years of experience with / knowledge of medications and pharmacy claims processing
• Must reside in Maine
• Ability to work remotely in a home office environment with access to high-speed internet within a HIPPA Compliant work space

Preferred Qualifications:  

• 2+ years of Pharmacy Technician experience. Will consider prior work in an MD office or clinic, call center, or prescription insurance company
• Proven knowledge of Microsoft Office including use of online collaboration tools such as Teams
• Proven knowledge of claims adjudication  

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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