Pharmacy Technician (Outpatient) - PTSS
3 days ago
Salem
Job Description Job Title: Pharmacy Technician (Outpatient) Location: Portland, OR Type: Local or Travel Contract (26 Weeks) Shift & Schedule: Day Shift | 5 x 8-Hour Shifts | 40 Hours Per Week | 8:00 AM – 5:00 PM | On-Call: 2–3 Weekends per Year Pay Rate: Local: $30 - $34/hr Travel: $35 - $41/hr Including Stipend (Based on Experience) Position Overview: Navitas Healthcare, LLC is seeking an Outpatient Pharmacy Technician for an exciting Local or Travel job in Portland, OR. Responsibilities • Process pharmacy prior authorizations independently using established policies and approval criteria., • Review pharmacy benefits, medication utilization policies, and member eligibility information., • Communicate with members, providers, pharmacies, customer service teams, and regulatory agencies regarding pharmacy-related inquiries., • Serve as a liaison between physicians, pharmacists, office staff, hospitals, members, and payors to resolve issues and facilitate workflows., • Perform intake, triage, documentation, and data entry for authorizations, referrals, medication management programs, and utilization reviews., • Research and resolve pended claims, authorizations, and incomplete records., • Audit pharmacy claims, documentation, and correspondence to ensure accuracy and compliance., • Assist with coding and review processes utilizing ICD-10, CPT, and HCPCS coding systems., • Authorize pharmacy claims and direct member reimbursements according to established guidelines., • Analyze data, prepare reports, and support quality improvement initiatives., • Maintain confidentiality and compliance with HIPAA, state, and federal regulations., • Develop written communications, procedures, and educational materials for providers, pharmacies, and health plan members., • Provide training and technical support regarding pharmacy processes and system usage., • Utilize pharmacy systems, claims processing systems, and Microsoft Office applications, including advanced Excel functions. Required Qualifications • Active Oregon Pharmacy Technician License., • Advanced Microsoft Excel skills., • Bachelor's Degree preferred or a minimum of 2 years of experience as a Pharmacy Technician in a managed care environment., • Experience handling prior authorizations and mandatory audits across Medicare, Medicaid, Commercial, Individual, and ASO plans., • Strong knowledge of pharmacy benefits, claims processing, medication utilization management, and health plan operations., • Working knowledge of medical terminology, HCPCS, CPT, and ICD-10 coding., • Knowledge of pharmacy billing, pharmaceutical calculations, and medication management programs., • Understanding of HIPAA, federal and state pharmacy regulations, and fraud, waste, and abuse prevention., • Excellent verbal, written, analytical, problem-solving, and customer service skills., • Ability to manage multiple priorities and work independently in a fast-paced environment., • Strong attention to detail and commitment to accuracy. Preferred Qualifications • Bachelor's Degree., • Managed care pharmacy experience., • Experience supporting pharmacy benefit administration and health plan operations., • Experience with data analysis, reporting, and quality improvement initiatives. For more details contact at hdavda@navitashealth.com or Call / Text at 516-862-1169. About Navitas Healthcare, LLC: It is a Joint Commission Certified / WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.