Job Description Responsibilities: • Under the general supervision of the Supervisor of Pharmacy Prior Authorization Technicians, the Pharmacy Services Technician I assists in the prior authorization process. • Reviews and approves physician inquiries for pre-authorization and medical necessity requests based on established pharmacy guidelines and contract criteria. • Supports Fraud and Abuse program system oversight by reviewing medication utilization records. Communicates any suspected fraud discovered. • Recommends course of action for providers where patterns appears outside of guidelines and generally accepted pharmacy standards. • Keeps abreast of industry trends and regulatory changes in the pharmacy industry and incorporates knowledge in the performance of job duties. • Identifies problems in process/procedures or services and makes recommendations for improvements. Maintains a balance of productivity, quality • timeliness of job accountabilities. Participates in department self-audit procedures for on-going evaluation of service. • Maintains and updates internal databases. Enters application information, prior authorizations and other relevant data. • Ensures database information and appended files are current and accessible to staff. Generates reports and other information requested on a scheduled/as needed basis. • Creates and supports an environment which fosters teamwork, cooperation, respect and diversity. Establishes and maintains positive communication and professional demeanor with AMFC employees and clients at all times. • Performs other related duties as assigned. • Attends required training on an annual basis. Qualifications • High School Graduate or GED equivalent - Required • Pharmacy Experience - 2 Years - Required • Minimum 35 words per minute typing speed - Required Additional Information All your information will be kept confidential according to EEO guidelines.