Remote Pharmacy Technician

Job Title: Remote Pharmacy Technician

Job Description

We are seeking a dedicated Pharmacy Technician to join our team, specializing in working with Medicare and Medicaid patients, primarily focusing on Medicare. The role involves managing prior authorizations, with a focus on intake and tech review processes. This is a fully remote position, providing flexibility and the opportunity to contribute to patient care from the comfort of your home.

Responsibilities

• Manage the intake of MedPharm prior authorizations and set up PAs in the system.
• Send cases to the review tech after initial setup.
• Conduct tech reviews by evaluating PA cases received from the intake team.
• Read and analyze criteria, SOPs, insurance documents, and medical documents to determine eligibility.
• Make clinical determinations regarding medication approval, denial, or coverage.

Essential Skills

• Experience in data entry and pharmacy operations.
• Pharmacy Technician Certification.
• Experience with managed care and claims processing.
• Prior Authorization expertise.
• Strong customer service skills.
• Proficiency in computer skills and the ability to work remotely and independently.

Additional Skills & Qualifications

• Managed care experience.
• Pharmacy experience.
• Ability to handle customer service calls effectively, including controlling and redirecting conversations as needed.
• Cpht certification.

Work Environment

This position is 100% remote, requiring a closed-door setting with limited distractions to maintain HIPAA compliance. A strong Wi-Fi connection is essential to perform duties effectively from home. The initial training schedule is Monday to Friday, 10:00 AM to 6:30 PM EST, with holidays rotating among team members. The preferred working schedule is Tuesday to Friday from 12:30 PM to 9:00 PM EST, and Saturday from 8:00 AM to 4:30 PM EST. Lunch breaks range from 30 minutes to an hour, offering flexibility.