Optum ยท 2 months ago
Senior Pharmacy PA/Appeals Technician
United States
Full-time
Remote
Mid, Senior Level
$17.74/hr - $31.63/hr
0+ years expOptum is a global organization that delivers care aided by technology to help millions of people live healthier lives. The Senior Pharmacy PA/Appeals Technician role involves providing expertise and customer service support for prior authorization requests for medications, ensuring compliance with legal and contractual requirements while maintaining a high level of customer service.
EducationHealth CareMedicalPharmaceutical
Responsibilities
Manages a high volume of inbound and outbound calls, averaging 50+ daily
Answering Prior Authorization inquiry calls/requests with customer service skills as well as research, clinical information system utilizations and resolve formulary and benefit issues using the appropriate reference material
Process prior authorizations through multiple computer systems and use of job aids/policies/procedures ensuring the accuracy and compliance of all data and updating as necessary
Resolve issues and complaints in a timely manner
Handle inbound phone requests and gathers member data to provide information for pharmacist consultations
Have sharp attention to detail, using established criteria and guidelines, the pharmacy technician receives and processes prior authorization requests made by providers and members for medications not inherently covered on a member's prescription drug plan
Performs other duties as assigned by management
Patient Safety and Quality of work is paramount and it's important for employees to have a safe and secure workspace and communicate with their leadership when that safety (equipment, system, information) is compromised
Promote a culture of safety that is equitable, transparent, and engaging for patients, family caregivers, and healthcare workforce
Enhance workforce safety and well-being by mitigating physical and psychological risks, analyzing hazard data, and implementing supportive workplace strategies
Leadership will oversee the monitoring of safety event trends, provide feedback of safety initiatives, quality improvement efforts, and governance in order to develop responsive measurable action plans
Qualification
Required
Active and unrestricted Pharmacy Technician license in the state of Wyoming
Active and unrestricted Pharmacy Technicians Certification Board (PTCB) OR ExCPT - Pharmacy Technician Certification with National Healthcareer Association (NHA)
6+ months of experience in customer service/customer relations with healthcare professionals
Basic level of proficiency with Microsoft Excel (ability to create, edit, and save a basic spreadsheet), Microsoft Word (ability to create, edit, and save a basic document), and Microsoft Outlook (ability to send emails)
Currently located in the state of Wyoming
Ability to work any shift from 5:00 AM to 12:00 AM timeframe with flexible hours, including OT and weekends and a rotating on call schedule every 3 weeks for 7 days in row
Preferred
Knowledge of Call Center systems such as CMS, IEX, CTI and TCS
Benefits
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 ReimbursementA
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
Company
Optum
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.
10001+ employees
H1B Sponsorship
Optum has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (648)
2024 (559)
2023 (620)
2022 (851)
2021 (593)
2020 (438)
Funding
Current Stage
Late StageLeadership Team
Daniel Castillo
Chief Executive Officer, Optum Care Delivery
J
Jay Green
Chief Financial Officer
Recent News
2025-11-29
2025-11-19
2025-11-07
Company data provided by crunchbase