Pharmacy Technician – Prescription Routing & Claims Support at Philo

Scottsdale, Arizona, United States

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Not SpecifiedCompensation

Entry Level & New Grad, Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Health Tech, PharmacyIndustries

Requirements

Arizona or Ohio Pharmacy Technician License (required)
PTCB certification (preferred)
Minimum 1 year of pharmacy technician experience, preferably in a Specialty, Mail Order, PBM (with Manufacturer and Insurance troubleshooting experience) or Retail setting
Working Knowledge of Insurance claim rejections (e.g., Reject 50/40, DUR codes, etc.)
Working Knowledge of Prior authorizations, override codes, and split billing scenarios

Responsibilities

Troubleshooting electronic, faxed, and verbal prescriptions via routing to appropriate channels into pharmacy systems
Review and update patient insurance using payer portals and phone resources
Determining appropriate situations for a prior authorization (PAs) need via payer-specific tools; troubleshoot denials and escalations
Utilize reroute best practices for orders falling outside normal workflow, including orders with state changes, insurance exceptions, pharmacy rejections, or failed transfers
Navigate operational platforms (e.g., BestRx, Ops Dash, Partner Dash, RelayHealth, etc.) and vendor systems effectively
Follow reroute protocols for specific tags including: non-contracted pharmacies, state shipping changes, PP send-backs, transfer not received, and more
Proactively document process notes with clear routing details, claim updates, and actions taken
Communicate with partner pharmacies, provider offices, and insurance carriers to resolve issues or clarify documentation
Collaborate with At-Risk, Partner Management, and PPM teams to escalate or flag orders based on system outages, stock issues, or policy refusals
Maintain productivity in the Reroute queue even during extended call hold times (e.g., multitask during insurance calls)
Ensure all patient, prescriber, and partner communications are clear, professional, and aligned with Phil’s standards of care

Skills

Insurance Verification

Payer Portals

Prior Authorization

Prescription Routing

Claims Troubleshooting

Pharmacy Systems

Patient Communication

Denials Escalation

Philo

Subscription-based streaming service for TV channels

About Philo

Philo offers a streaming service that gives users access to over 60 popular TV channels, such as A&E, AMC, and Comedy Central. It operates as an alternative to traditional cable subscriptions, allowing consumers to enjoy a variety of entertainment options without the high costs associated with cable. Users can subscribe to Philo on a monthly basis, and the service includes features like unlimited DVR, enabling them to record shows and watch them later. Philo can be accessed on multiple devices, making it convenient for users to watch their favorite programs anywhere. The company aims to provide a cost-effective and flexible viewing experience, appealing to those looking for a simpler way to enjoy television.

San Francisco, CaliforniaHeadquarters

2011Year Founded

$151.5MTotal Funding

SERIES_DCompany Stage

Consumer Software, EntertainmentIndustries

51-200Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

401(k) Retirement Plan

401(k) Company Match

Flexible Work Hours

Paid Vacation

Paid Sick Leave

Paid Holidays

Parental Leave

Unlimited Paid Time Off

Family Planning Benefits

Fertility Treatment Support

Professional Development Budget

Conference Attendance Budget

Home Office Stipend

Phone/Internet Stipend

Wellness Program

Gym Membership

Commuter Benefits

Employee Discounts

Company Social Events

Risks

Rising content acquisition costs may challenge Philo's low-cost subscription model.

Increased competition from services like Peacock and HBO Max threatens Philo's market share.

Dependence on third-party platforms like Vizio could limit Philo's app availability.

Differentiation

Philo offers a cost-effective alternative to traditional cable with over 60 channels.

The service includes unlimited DVR and multi-device streaming, enhancing user flexibility.

Philo's focus on entertainment channels caters to niche content demand.

Upsides

Philo's partnership with Dish Media expands its addressable advertising reach to over 1 million households.

The addition of new channels like Me TV Plus aligns with growing interest in niche content.

Philo's launch on Vizio smart TVs taps into the 80% smart TV household market.

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