Job Title: Pharmacy Technician

Job Description

We are seeking dedicated pharmacy technicians to join a healthcare insurance company. In this role, you will be responsible for reviewing Prior Authorizations for coverage determination in a Pharmacy Services department. You will either approve or deny these authorizations and then forward them to pharmacists for final review. This position involves handling all health plans and types of medications with minimal phone work, primarily outbound calls.

Responsibilities

• Track coverage determination requests and obtain verbal authorizations.
• Approve requests based on criteria and enter decisions into the PBM system.
• Notify providers and members of decision outcomes.
• Respond to client inquiries and refer requests for specialty drugs.
• Contact providers for additional information and obtain detailed clinical information from prescribers.
• Assist with inbound and/or outbound patient or physician calls, if needed.

Essential Skills

• High School diploma or GED.
• Current pharmacy registration and certification as required by state of operation.
• Strong computer skills, including proficiency in Microsoft Office and data entry.
• Experience with prior authorization and prescription benefits.
• Registered Pharmacy Technician and Certified Pharmacy Technician credentials.

Additional Skills & Qualifications

• Experience in retail pharmacy, hospital, or specialty pharmacy settings.
• Knowledge of Medicare, Medicaid, and insurance health plans.
• Excellent customer service skills.
• Certification from PTCB or NHA.

Work Environment

This is a remote position within a professional environment. You will work with multiple screens and systems, requiring a strong wifi connection and a dedicated office space with a closed door.