WellDyne · 8 hours ago
Prior Authorization Technician I
United States
Full-time
Remote
Entry Level
2+ years expWellDyne is committed to providing quality pharmacy care and is seeking a Prior Authorization Technician I to process administrative prior authorization requests. The role involves handling calls from pharmacies, physicians, and members, ensuring effective resolution of inquiries while maintaining confidentiality of PHI.
Call CenterConsultingHealth CareOutsourcingPharmaceuticalWellness
Responsibilities
Responsible for taking administrative PA calls from pharmacies, physicians’ offices and members with the goal being a first call resolution. These calls with include, but are not limited to refill too soon requests, vacation override requests, claim dollar override requests, DUR, etc
Accountable for placing call notes in the appropriate areas every time a PA request is handled
Works closely with pharmacies, providers, and members to resolve any questions or issues involving PA’s
Responds in a prompt, professional, and courteous manner to pharmacy, provider and member inquiries regarding administrative prior authorizations
Ability to clearly identify problem, analyze situation, and rectify pharmacy, provider, or member concerns using established procedures
Ability to handle difficult people and problems by resolving matters in an effective and timely manner
Provides support to pharmacies having difficulty processing claims
Ensures all PA’s are placed into RxClaim correctly and in a timely manner
Applies appropriate policies, procedures, and eligibility and benefit policies
Maintains confidentiality of all PHI in compliance with state and federal law
Consistently meets established productivity, schedule adherence, and quality standards, while maintaining a good attendance record
Other duties as assigned
Qualification
Required
At least 2 years of pharmacy related experience
At least 2 years of customer service related experience
Strong telephone, verbal, and written communication skills
Knowledge of customer service principles and practices
Time Management Skills
Ability to work independently within team environment with little direct supervision
Ability to work in a high pace, stress environment
Ability to remain focused and productive each day though tasks may be repetitive
Strong attention to detail and effective follow-up skills
Ability to multi-task
Computer proficiency to navigate required databases and operate in required software packages
Ability to work under pressure
Demonstrated ability to handle problems tactfully
Maintains confidentiality of all PHI in compliance with state and federal law
Consistently meets established productivity, schedule adherence, and quality standards, while maintaining a good attendance record
Preferred
Registered Pharmacy Technician within the state of FL preferred
MS Office Suite knowledge (Which includes the ability to learn new and complex computer system applications)
Benefits
Medical, Dental and Vision Benefits
Medical Savings Account Options with Company match
401K after 90 days of employment
Employee Assistance Program
Life and Supplemental insurance
Educational Reimbursement
Paid Time Off
Career Pathing
Company
WellDyne
WellDyne is a healthcare industry.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
unknown2016-08-01Acquired
Leadership Team
David Skomo
Chief Operating Officer
Phil Bisesi
SVP, General Counsel and Chief Compliance Officer
Recent News
Fierce Healthcare
2025-05-23
2022-03-24
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