Remote Appeals Specialist - PBM Pharmacy

Judi Health; Denver (CO); On-site; USD 72,000 - 90,000; Full time

Job summary

Judi Health, a Denver-area remote-friendly health technology company, seeks a Pharmacy Technician specialist to handle first, second, and external appeal requests for Commercial, Exchange and Medicare lines. The role emphasizes patient/member communication, HIPAA compliance, and high-quality service.

You will work in a remote environment across US time zones, collaborating with pharmacists and medical directors to ensure accurate submission and timely resolutions.

Qualifications

• Certified Pharmacy Technician with PBM/managed care exposure.
• PTCB or NHA certification required.
• Strong organization and communication skills; detail oriented.

Responsibilities

• Manage incoming requests for first and second level appeals.
• Coordinate with pharmacist and medical directors for external appeals.
• Maintain quality and productivity standards within turnaround times.

Skills

Certified Pharmacy Technician

PBM Experience

Remote work experience

Education

PTCB or NHA Certification

Job description

Judi Health, a Denver-area remote-friendly health technology company, seeks a Pharmacy Technician specialist to handle first, second, and external appeal requests for Commercial, Exchange and Medicare lines. The role emphasizes patient/member communication, HIPAA compliance, and high-quality service.

You will work in a remote environment across US time zones, collaborating with pharmacists and medical directors to ensure accurate submission and timely resolutions.