Job Title: Pharmacy Technician

Job Description

We are seeking dedicated pharmacy technicians to join a dynamic team in the EST timezone. Technicians will be responsible for reviewing Prior Authorizations for coverage determination as part of a Pharmacy Services department within a large healthcare insurance company. The role involves approving or denying requests, which are then sent to a Pharmacist for final review. This position involves handling various health plans and medication types, with minimal phone work primarily involving outbound calls.

Responsibilities

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

Essential Skills

• High School diploma or equivalent.
• Current Pharmacy Registration and Certification as required by state of operation.
• Basic computer skills.
• Strong proficiency in Microsoft Office and Outlook.
• Pharmacy technician license.
• Certified Pharmacy Technician (CPhT).

Additional Skills & Qualifications

• National certification such as PTCB or NHA.
• Experience with prior authorization processes.
• Experience in retail pharmacy, call center, hospital, or specialty pharmacy settings.
• Familiarity with Medicare and Medicaid prescription benefits.

Work Environment

This is a professional remote work environment requiring strong WiFi and a private office space with a closed door. You will be working on multiple screens and systems. The schedule requires availability Monday through Friday, 8 am to 8 pm in your local timezone, with rotating weekends every 4-6 weeks and some holidays. Training is from 10 am to 6:30 pm EST, followed by a regular shift. Schedules are provided three months in advance. The company offers flexibility for those who meet metrics and have tenure. Equipment provided includes a computer, monitor, and headset.