Remote Certified Pharmacy Technician

Job Description

As a Pharmacy Technician, you will review Prior Authorizations for a Pharmacy Services department within a large healthcare insurance company. Your role involves making determinations to approve or deny these authorizations, which are then sent to a Pharmacist for final review. You will handle all health plans and types of medications, ensuring efficient processing and resolution.

Responsibilities

• Process prescription exceptions, including resolving claim rejects and conducting member and physician outreach.
• Enter member demographics and prescription information into the data processing system.
• Research and resolve rejected insurance billing issues and/or escalated member issues.
• Escalate prescription-related questions to a Pharmacist for interpretation or processing direction.
• Assist with inbound and/or outbound patient or physician calls.

Essential Skills

• High School diploma or GED.
• Current Pharmacy Registration and Certification as required by state.
• Basic computer skills.
• Strong computer skills and call center experience.
• Nationally Certified Technician and registered pharmacy technician in the state of residence.

Additional Skills & Qualifications

• Bilingual skills preferred.
• Experience in PBM, Hospital, or Specialty Pharmacy settings.
• Knowledge of prescription benefits.

Work Environment

This is a remote position requiring a strong Wi-Fi connection and a dedicated office space with a closed door. You will work in a professional environment, utilizing multiple screens and systems. Equipment such as a computer, monitor, and headset will be provided. The position requires availability Monday to Friday from 8 am to 8 pm in your time zone, with rotating weekend shifts every 4-6 weeks and potential holiday shifts. Training will be conducted from 10 am to 6:30 pm EST, after which shifts will start at 8 am, 9 am, or 10 am depending on your time zone. A smartphone is also required.