Position Summary :

As a Clinical Representative you will work closely with providers to process prior authorization (PA) and drug benefit exception requests in accordance with Medicare part D (Med D) regulations. In this role, you will research and conduct outreach via phone or fax to obtain additional information to process coverage requests and complete necessary actions to close cases. 



Additional responsibilities for the Clinical Representative include:

-Correcting issues related to PA and exception requests 

-Initiating and resolving coverage requests 

-Raising issues to coverage determination clinical pharmacists and management team as needed



Required Qualifications :

1+ years of experience using Microsoft Office Suites 

1+ years of Customer Service experience



Preferred Qualifications :

-National Pharmacy Technician Certification 

-Excellent verbal and written communication and interpersonal skills with the ability to maintain patient confidentiality 

-Demonstrated problem-solving ability and attention to detail 

-Ability to work in a rapidly changing environment 

-Strong organizational skills 

-Ability to read, analyze and interpret general business correspondence, technical procedures and governmental regulations 

-Ability to identify and solve practical problems and deal with multiple concrete variables in standardized situations 

-Ability to perform basic mathematic calculations maybe required 

-Ability to interpret various work instructions provided through several mediums



Education :

Verifiable GED or High School Diploma is required