Pharmacy Technician

Description

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

Requirements

• Prior Authorization expertise.
• Experience with managed care and claims processing.
• Pharmacy experience.
• Pharmacy Technician Certification.
• Cpht certification.
• Experience in data entry and pharmacy operations.
• Strong customer service skills.
• Managed care experience.
• 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 weekends and holidays rotating among team members.
• Proficiency in computer skills and the ability to work remotely and independently.
• Ability to handle customer service calls effectively, including controlling and redirecting conversations as needed.

Benefits

• Employee Assistance Program
• Critical Illness, Accident, and Hospital
• Health Spending Account (HSA)
• Short and long-term disability
• Transportation benefits
• Medical, dental & vision
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Time Off/Leave (PTO, Vacation or Sick Leave)
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)

Training + Development

Interview process

Visa Sponsorship

Security clearance