Remote Certified Pharmacy Technician - Prior Authorization

Actalent; Houston (TX); Remote; USD 25,000 - 30,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Pre-tax and Roth post-tax benefits

Short/long-term disability

Health Savings Account (HSA)

Transportation benefits

Paid time off (PTO)

Job summary

Actalent is seeking a Certified Pharmacy Technician for a 100% remote contract role based out of Houston, TX. You will evaluate and authorize commercial prior authorization requests using clinical criteria in a call center environment, communicating decisions to prescribers and healthcare staff.

The role requires documenting outcomes in the pharmacy system, escalating complex cases to a Pharmacist, and maintaining productivity across multiple queues while adapting to team needs.

Qualifications

• Previous experience in pharmacy benefit, prior authorization, healthcare, or commercial insurance preferred.
• Customer service, call center, healthcare, pharmacy, or insurance experience is advantageous.

Responsibilities

• Evaluate and authorize commercial prior authorization pharmacy requests from prescribers received by telephone.
• Determine appropriateness for medications and communicate decisions to physicians, physician office staff, medical management staff, and pharmacists.
• Document prior authorization outcomes in the pharmacy system.
• Communicate selected prior authorization criteria, pharmacy benefit coverage, and formulary alternatives.
• Escalate requests to Pharmacist for extensive clinical review or denial.
• Document physician or client inquiries and grievances, providing verbal or written results.
• Work in the fax queue, clinically reviewing coverage determinations for medications.
• Efficiently multitask and monitor several queues and assignments, adapting to team requirements.

Skills

Pharmacy benefit knowledge

Prior authorization experience

Call center experience

Customer service skills

Job description

Actalent is seeking a Certified Pharmacy Technician for a 100% remote contract role based out of Houston, TX. You will evaluate and authorize commercial prior authorization requests using clinical criteria in a call center environment, communicating decisions to prescribers and healthcare staff.

The role requires documenting outcomes in the pharmacy system, escalating complex cases to a Pharmacist, and maintaining productivity across multiple queues while adapting to team needs.