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Senior Pharmacy PA / Appeals Technician - Sugar Land, TX

Company: UnitedHealth Group
Location: Sugar Land
Posted on: June 29, 2018

Job Description:

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.


Primary Responsibilities:

Verify appropriate Member and Provider information.
Contact Patients, Pharmacists, and Doctor's offices to resolve Claims issues.
Resolve customer issues; ensuring accurate information is provided.
Consistently meet established productivity, schedule adherence, and quality standards while maintaining a good attendance record.
Contact Doctor's offices to obtain information necessary to determine if the Drug Claim is covered under the member's pharmacy benefits. Outreach will be performed via phone and electronically (e.g. fax).
Reach out to Members for assistance in securing information from their doctor.
Accurate, timely, and detailed documentation of each Outreach attempt.
Collaboration with Pharmacists and Medical Directors, ensuring coverage criteria is clearly communicated to the Physicians and their office personnel.
Provider Outreach to obtain additional information necessary for the Pharmacist or Medical Director to render a coverage decision.
Excellent oral and written communication skills.
Ability to remain focused and productive each day, though tasks may be repetitive.
Continued employment is contingent upon successful Pharmacy Technician licensing and registration, as required.


Required Qualifications:

High School Diploma / GED or higher
Current State Pharmacy Technician License and National Certification without restrictions based on regulatory requirements of the State of Texas
1+ years of Pharmacy Technician experience
1+ years working experience with Microsoft Office - Word to create, save and report documents and Excel to create, save and report spreadsheets
Experience with Windows-based applications, including the ability to learn new and complex systems
Available to work 40 hours per week including weekends and overtime as required according to the needs of the business

Preferred Qualifications

Medicare and / or Medicaid knowledge
Experience with project management
2+ years of Pharmacy related experience

Soft Skills:

Prior stable work experience
Ability to remain focused and productive each day though tasks may be repetitive

Physical Requirements and Work Environment:


Frequent speaking, listening using a phone headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods of close vision looking at a computer monitor.

Service Center environment with moderate noise level due to representatives talking, computers, printers, and floor activities.


Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM


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.




Keywords: pharmacy, appeals, senior, Sugar Land, TX, technician, clinical, grievances, UHG, UnitedHealthGroup.

Keywords: UnitedHealth Group, Sugar Land, Senior Pharmacy PA / Appeals Technician - Sugar Land, TX, Professions, Sugar Land, Texas

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