Job Title: Remote Pharmacy Technician

Job Description

Pharmacy technicians will operate in an EST timezone, primarily reviewing Prior Authorizations for coverage determination within a Pharmacy Services department associated with a large healthcare insurance company. They will be responsible for approving or denying requests and forwarding them to a pharmacist for final review. This role involves handling all health plans and types of medications with minimal phone interaction, mostly outbound.

Responsibilities

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

Essential Skills

• High School diploma or equivalent.
• Current Pharmacy Registration and Certification as required by the state of operation.
• Strong computer skills, including Microsoft Office and Outlook.
• Experience with data entry and customer service.
• Registered Pharmacy Technician and Certified Pharmacy Technician credentials.
• Prior authorization experience.

Additional Skills & Qualifications

• Experience in retail pharmacy, call center, hospital, or specialty pharmacy settings.
• Knowledge of Medicare and Medicaid.
• Experience with prescription benefits management.
• National certification (e.g., PTCB, NHA).

Work Environment

This is a professional remote environment where you will work across multiple screens and systems. You must have a strong Wi-Fi connection and a dedicated office space with a closed door. The schedule requires availability Monday through Friday, 8 AM to 8 PM in your local time zone, with rotating weekends every 4-6 weeks and some holidays. Holiday schedules will be bid for. Training will occur from 10 AM to 6:30 PM EST. After training, regular shifts are assigned with schedules sent three months in advance. The company provides necessary equipment, including a computer, monitor, and headset.