Job Title: Remote Certified Pharmacy Technician

Job Description

We are seeking a dedicated Remote Pharmacy Technician to join our team working in the EST time zone. As a Pharmacy Technician, you will be responsible for reviewing Prior Authorizations for coverage determination for a Pharmacy Services department within a large healthcare insurance company. You will make initial approval or denial decisions before passing them to Pharmacists for final review.

Responsibilities

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

Requirements

• High School diploma or GED
• State Registration AND National Certification
• Basic computer skills
• Experience with Prior Authorization processes
• Proficiency in Microsoft Office and Outlook
• Data entry skills

Work Environment

• This is a professional remote environment where you will work with multiple screens and systems.
• You must have a strong WiFi connection and a dedicated office space with a closed door.
• The shift is Monday to Friday, from 8 am to 8 pm (Open for 8-hour Shifts), with rotating weekends every 4-6 weeks and some holidays.
• Training is conducted from 10 am to 6:30 pm EST.
• The company provides equipment, including a computer, monitor, and headset.