Pharmacy Technician (US: FL, IL, IN, WI)

Snaphunt; Orlando (FL); Remote; USD 45,000 - 65,000; Full time

Job summary

A leading company is seeking a remote Clinical Review Technician to provide quality service in line with clinical standards. This role involves reviewing patient information, making service approvals, and ensuring adherence to company policies. Candidates should have a pharmacy technician license, strong communication skills, and experience in customer service or related fields.

Benefits

100% remote based working

Flexible working schedule

Breadth of learning opportunities

Qualifications

• 2 to 4 years in customer service, supply chain, or call center.
• Strong written and verbal skills in English and high-level Spanish.
• Certified Pharmacy Technician preferred.

Responsibilities

• Review patient information and check appropriateness using clinical criteria.
• Make approval recommendations on services that meet review criteria.
• Provide optimum customer service through professional communication.

Skills

Customer Service

Communication Skills

Organizational Skills

Interpersonal Skills

Multitasking

Education

Associate degree or equivalent experience

Active Illinois Pharmacy Technician License

Job description

The Offer

• 100% remote based working
• A role that offers a breadth of learning opportunities
• Flexible working schedule

Ideal Candidate

Key Responsibilities:

• Review pertinent patient information and check appropriateness using clinical criteria.
• Make approval recommendations on all services that meet clinical review criteria. Refer all cases not meeting clinical criteria to pharmacist clinical reviewer.
• Practice and maintain the principles of utilization management by adhering to company policies and procedures.
• Uphold clinical integrity of pharmaceutical solutions by participating in ongoing training programs to ensure quality performance in compliance with applicable standards and regulations.
• Assist with the documentation and implementation of both written and verbal communications to physicians/prescribers and assist in the maintenance of the edits and data elements that support the edits.
• Be available for consultation on pharmacy-related questions to resolve claims submission related to medication edits.
• Contact physicians/prescribers to obtain pertinent clinical history/information.
• Provide optimum customer service through professional/accurate communication while maintaining NCQA and health plan’s required timeframes.
• Regularly review and monitor information on pended claims identified as outliers by internal and/or external analysis of pharmacy claims data.
• Support Intake call volume and order entry if necessary.
• Determine eligibility for medication reimbursement based upon established clinical criteria and clinical knowledge and enter approvals or denials in the system.
• Electronically document both written and verbal communications with physicians, their staff, cardholders, and pharmacies.
• Escalate medical exception requests to nurse, pharmacist, or physician on the utilization review clinical team when further review is necessary.

The Profile

Mandatory Requirements

• Active Illinois Pharmacy Technician License (or must obtain before training begins)
• Reside in Florida, Indiana, Illinois, or Wisconsin

Qualifications

• Associate degree or equivalent experience preferred
• 2 to 4 years of experience in customer service, supply chain, or call center environments (U.S.-based)
• Certified Pharmacy Technician preferred
• Strong written and verbal communication skills with native English and high-level Spanish
• Excellent organizational and interpersonal skills
• Ability to multitask in a fast-paced environment
• Strong orientation towards metrics and KPIs
• Experience interacting professionally with patients, RNs, and medical personnel

The Employer

Our client is a Revolutionary Multilingual Cloud Contact Center and the International Marketplace of Premium Customer Support Projects for Remote Talents.