Senior Pharm PA/Appeals Technician – Remote in Vermont

About the position

The Senior Pharmacy Prior Authorization Appeals Technician at UnitedHealth Group is responsible for providing expertise and customer service support to members, customers, and providers regarding prior authorization requests for medications. This remote position requires handling a high volume of inbound calls, processing authorizations, and ensuring compliance with legal and contractual requirements while maintaining a high level of customer service. The role emphasizes patient safety, quality of work, and effective communication with leadership regarding workspace safety.

Responsibilities
• Answer inbound calls for prior authorization requests from providers and members (up to 50 to 70 calls per day).
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• Research and resolve formulary and benefit issues using appropriate reference materials.
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• Process authorizations through various computer systems, ensuring data accuracy and updates as necessary.
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• Receive and process prior authorization requests for medications not covered on a member’s prescription drug plan.
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• Document interactions with callers per contractual and regulatory requirements.
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• Resolve issues and complaints in a timely manner.
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• Gather member data for pharmacist consultations during inbound phone requests.
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• Complete training for 5 weeks, Monday to Friday, from 8:00 am to 5:00 pm local time.
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• Work an 8-hour shift with an hour lunch after training, with availability from 5 am to midnight.
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• Work 5 days a week, which may include weekends, with potential for scheduled overtime and holiday work.

Requirements
• Active National Pharmacy Technician Certification from PTCB, ExCPT, or the National Board of Prior Authorization Specialist.
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• 6+ months of customer service experience with healthcare professionals.
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• Basic proficiency in Microsoft Excel, Word, and Outlook.
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• Ability to work flexible hours, including overtime and weekends.
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• Must reside in the state of Vermont.

Nice-to-haves
• Knowledge of call center systems such as IEX.

Benefits
• Paid Time Off starting with the first pay period plus 8 Paid Holidays and a Floating Holiday.
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• Medical Plan options with Health Spending Account or Health Saving Account participation.
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• Dental, Vision, Life & AD&D Insurance, Short-term and Long-term Disability coverage.
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• 401(k) Savings Plan and Employee Stock Purchase Plan.
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• Education Reimbursement.
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• Employee Discounts and Employee Assistance Program.
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• Employee Referral Bonus Program.
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• Flexible Work Arrangement.
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• Voluntary Benefits such as pet insurance and legal insurance.