Job Title: Pharmacy Technician

We are seeking a dedicated Pharmacy Technician to join a large healthcare insurance company's Pharmacy Services department. The primary role involves reviewing Prior Authorizations for medications, making initial approval or denial decisions, and forwarding them to pharmacists for final review. This position requires handling various health plans and medications, with minimal phone interaction with members.

• Track coverage determination requests submitted by providers and assess if a pharmacist review is required.
• Obtain verbal authorizations and request detailed clinical information from prescribers.
• Approve coverage determination requests based on predefined criteria.
• Document coverage determination request decisions in the PBM system and notify providers and/or members.
• Respond to client inquiries regarding authorization approvals and PBM online applications.
• Refer coverage determination requests for specialty drugs to the designated vendor or client for processing.
• Contact providers for additional information to facilitate coverage determination reviews.
• Notify physicians, providers, and members of coverage determination request decisions.

• High School diploma or equivalent.
• Current Pharmacy Registration and Certification as required by the state of operation.
• Proficiency in basic computer skills.
• Strong customer service skills.

• Registered pharmacy technician in the state of residence.
• Nationally Certified Technician is a plus; required for some supervisory roles.
• Strong computer skills, including familiarity with Microsoft Office and Outlook.
• Experience with prior authorization, PBM systems, and data entry.
• Experience in call centers, hospitals, or specialty pharmacies.

This is a professional remote position requiring a strong Wi-Fi connection and a dedicated office space with a closed door. Employees will work in multiple screens and systems. The shift requires availability Monday through Friday from 8 AM to 7 PM in your time zone, with rotating weekends and some holidays. Training occurs Monday to Friday, 10 AM to 6:30 PM EST. Employees must have a smartphone; equipment such as a computer, monitor, and headset will be provided. Opportunities for overtime and shift flexibility are available.

This is a Contract to Hire position based out of ORLANDO, FL.