Prior Authorizations Pharmacy Technician - REMOTE

Actalent; Orlando (FL); Remote; USD 28,000 - 32,000; Full time

Benefits offered by this job

Remote position

Growth opportunities

Prior authorizations experience

Job summary

Actalent is hiring a Remote Pharmacy Technician to support coverage determinations and prior authorizations for Medicare Part D. The role reviews requests, gathers clinical data, and documents decisions in the PBM system, with minimal phone work and a focus on accuracy and timeliness.

Requirements include an active pharmacy license, HS diploma or GED, and 1+ year of experience in a retail, hospital, or mail-order setting. NHA or PTCB certification is preferred.

Qualifications

• Active state or national pharmacy technician license required.
• Pharmacy technician certification or equivalent credential required.
• Minimum 1 year of experience in a retail, hospital, or mail order pharmacy setting.
• High school diploma or GED required.
• Experience with PBM or coverage determinations preferred.
• Strong verbal communication skills for obtaining authorizations and clinical details.
• Ability to document information and decisions in PBM systems.

Responsibilities

• Track and triage all coverage determination requests for prior authorizations.
• Review requests and determine when pharmacist review is required.
• Obtain verbal authorizations from prescribers and request detailed clinical information.
• Approve coverage determinations based on defined criteria.
• Enter and document coverage decisions in the PBM system.
• Notify providers and members of outcomes clearly and promptly.
• Respond to inquiries regarding approvals and PBM applications.
• Refer complex requests to the appropriate delegated vendor or client.
• Contact providers to obtain additional information needed.

Skills

Pharmacy license

Pharmacy tech certification

1+ year experience

Verbal communication

PBM documentation

Interpretation of criteria

Education

HS diploma or GED

Tools

PBM software

Job description

Job Title: Remote Pharmacy Technician

We are hiring for a 100% REMOTE Pharmacy Technician ASAP!

Leading healthcare company is looking for a certified pharmacy technician to join their team! This role will focus on prior authorizations processing and has very minimal work over the phone.

What's In It For You

• REMOTE position
• Opportunity to grow within managed care
• Gain experience working with prior authorizations

Requirements

• Experience with prior authorizations
• Ability to work the below schedule:
• Monday-Friday, some weekend work and holiday coverage after training
• scheduled for an 8-hour shift between 8am-6:30pm EST
• HS diploma OR GED
• NHA or PTCB certification preferred

Job Description

The Pharmacy Technician supports coverage determination and prior authorization activities for Medicare Part D recipients by reviewing requests, gathering clinical information, and documenting decisions in the pharmacy benefit management system. This role works closely with prescribers, providers, and members to ensure timely and accurate processing of coverage determinations while providing clear communication and support throughout the authorization process.

Responsibilities

• Track and triage all coverage determination requests for prior authorizations.
• Review coverage determination requests submitted by providers and determine when a pharmacist review is required.
• Obtain verbal authorizations from prescribers and request detailed clinical information to support coverage decisions.
• Approve coverage determination requests based on defined clinical and plan criteria.
• Enter and document coverage determination decisions accurately in the pharmacy benefit management (PBM) system.
• Notify providers and members of coverage determination outcomes in a clear and timely manner.
• Respond to client inquiries regarding authorization approvals and the use of PBM online applications.
• Refer coverage determination requests for specialty medications to the appropriate delegated vendor or client for processing.
• Contact providers to obtain additional information needed to complete coverage determination reviews.
• Communicate coverage determination decisions to physicians, providers, and members, ensuring they understand the outcome and next steps.

Essential Skills

• Active State or National Pharmacy Technician license.
• Pharmacy technician certificate or equivalent credential.
• At least 1 year of experience in a retail, hospital, or mail order pharmacy setting.
• High school diploma or equivalent.
• Experience working in a mail order pharmacy or retail pharmacy environment.
• Ability to accurately document information and decisions in a PBM or similar system.
• Strong verbal communication skills for obtaining authorizations and clinical details from prescribers.
• Ability to interpret and apply defined criteria for coverage determinations and prior authorizations.

Work Environment

This position operates in a professional pharmacy or pharmacy benefit management environment that relies heavily on computer-based systems and data entry. You will spend most of your time working at a workstation using PBM and related software to process coverage determination requests. The role traditionally follows structured hours aligned with business operations, with a focus on timely response to provider, member, and client inquiries. The environment emphasizes accuracy, confidentiality, and adherence to regulatory and internal policies. Professional attire appropriate for an office or clinical support setting is expected.

Job Type & Location

This is a Contract to Hire position based out of ORLANDO, FL.

Pay And Benefits

The pay range for this position is $20.00 - $23.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave).

Application Deadline

This position is anticipated to close on Nov 11, 2026.

Workplace Type

This is a fully remote position.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email [e-mail] for other accommodation options.

San Francisco Fair Chance Ordinance

Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI)

We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.