Job Title: Pharmacy Technician

Job Description

The Pharmacy Technician will be responsible for reviewing Prior Authorizations within the Pharmacy Services department of a large healthcare insurance company. The role involves approving or denying authorizations and forwarding them to a Pharmacist for final review. The Technician will handle all health plans and types of medications.

Responsibilities

• Process prescription exceptions, which may include resolving claim rejects and 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 questions regarding prescriptions to a Pharmacist for interpretation or provide direction on processing.
• Assist with inbound and outbound patient or physician calls.

Essential Skills

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

Additional Skills & Qualifications

• Experience with Microsoft Office, including Outlook.
• Certification as a Pharmacy Technician, registered pharmacy technician, or equivalent.
• Experience in call centers, PBM, hospitals, or specialty pharmacy.
• Experience with prescription benefits.

Work Environment

This is a professional remote environment, requiring the ability to work in multiple screens and systems. The position requires strong WiFi and a dedicated office space with a closed door. Equipment including a computer, monitor, and headset will be provided. Shift hours are Monday through Friday from 8am to 8pm in the candidate's time zone, with rotating weekends every 4-6 weeks and some holidays. Training will be conducted from 10am to 6:30pm EST, and shifts will begin at 8am, 9am, or 10am in the candidate's time zone post-training. A smartphone is required.