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What does a pharmacy tech do for an insurance company?

I am a certified pharmacy tech and have an interview with Humana Thursday. What would my job entail? I don't want to look like an idiot when I go to the interview and they ask me if I know what I am there for. I know it is an office job, and I know I would have to use the computer and call doctors and pharmacies and insurance companies, but what else would I be doing?

Public Comments

1. There are a number of jobs, depending on what you are interviewing for. Humana is most likely looking for people who have a basic understanding of drugs and possibly their uses. 1. You may be involved in the prior authorization process for coverage of a drug. Getting information from the physician to make a decision o if a drug is covered or not. 2. You could be involved in the audit process to make sure a drug was processed by the pharmacy correctly (correct day supply, quantity, etc). There could be other possible positions too. Your best bet in getting the position is to have good drug use knowledge, good communication skills and a desire to expand your knowledge.
2. Most likely you will assigned to the insurance company "pharmacy help desk". Your duties would include resolving problems. During the prescription online adjudication process claims are sometimes rejected by the insurance company. The pharmacy employee calls the insurance company "pharmacy help desk" to resolve rejections. Some common reasons for rejection that have to be resolved: NDC not covered Refills not covered Too soon to refill Patient not covered Invalid person code Insurance company computer unavailable for claim processing.