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Requisition Number 19-0091
Post Date 7/21/2019
Title Coverage Determination Analyst
City Birmingham
State AL
Description CPhTs and LPNs: Check out our great benefits, and consider joining our team!

The Coverage Determination Analyst is a Certified Pharmacy Technician or Licensed Practical Nurse who processes coverage determinations (prior authorizations and exception requests). This position receives, researches, documents, and processes the coverage determinations in a timely manner as required by regulatory requirements. This position also communicates decisions with providers, members, and internal staff as directed by management.
Requirements REQUIRED:
• High School diploma or GED
• CPhT (Certified Pharmacy Technician)
• Current CPhT License in good standing with the Alabama State Board of Pharmacy
• Demonstrate excellent customer service skills through written and verbal communication
• Basic computer skills
• Ability to work overtime and share after-hours, holidays, inclement weather, and weekend responsibilities
PREFERRED:
• Bachelor’s Degree or equivalent work experience
• Licensed Practical Nurse Certification
• Current LPN License in good standing with the State of Alabama Board of Nursing
• Customer service or call center experience
• Physician office experience
• Health Plan or PBM experience
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An Equal Opportunity Employer