Remote Appeals Technician — 12pm–9pm EST

Judi Health; Poland; Remote; PLN 45,000 - 65,000; Full time

Job summary

Judi Health is seeking a certified Pharmacy Technician to handle first and second level and external appeals for Commercial, Exchange, and Medicare lines. You will support pharmacists and medical directors, ensuring accurate submission and timely processing of appeals.

Responsibilities include maintaining productivity standards, HIPAA adherence, and effective communication with members and providers. This is a remote role with EST hours, requiring prior PBM experience and a strong

Qualifications

• 1+ years’ experience as a certified pharmacy technician in a managed care or PBM setting.
• Active, unrestricted PTCB or NHA certification.
• Excellent organizational skills and strong attention to detail.
• Strong oral and written communication skills.
• Ability to work independently in a remote, high-volume environment.
• Ability to work 12pm-9pm EST hours.

Responsibilities

• Maintain quality and productivity standards for all reviewed cases, meeting turnaround times.
• Communicate effectively with appeal pharmacists and internal teams.
• Follow HIPAA policies and company SOPs.
• Review cases to verify qualifications for appeal review.
• Perform triple checks to ensure quality of reviews.
• Update case types and share information with independent review organizations.
• Provide accurate information to members and providers over the phone.
• Record information obtained during calls and make outreach attempts when needed.
• Exhibit professional phone and communication skills with stakeholders.
• Perform other duties as assigned.

Skills

Organizational skills

Attention to detail

Oral and written communication

Independent work

Remote work

Education

PTCB or NHA Certification

Job description

Judi Health is seeking a certified Pharmacy Technician to handle first and second level and external appeals for Commercial, Exchange, and Medicare lines. You will support pharmacists and medical directors, ensuring accurate submission and timely processing of appeals.

Responsibilities include maintaining productivity standards, HIPAA adherence, and effective communication with members and providers. This is a remote role with EST hours, requiring prior PBM experience and a strong