Remote Certified Pharmacy Technician - Prior Authorization

Actalent; Orlando (FL); Remote; USD 25,000 - 30,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) plan

Paid time off

Job summary

Actalent seeks a Certified Pharmacy Technician for a fully remote, contract role in Medicaid prior authorizations. You will evaluate and authorize PA requests, document outcomes, and communicate decisions to physicians and staff from a high-volume call center.

The position requires CPhT certification and an active state license, with 1+ year in retail or call center pharmacy. Training is provided and the contract may extend after one year.

Qualifications

• National pharmacy technician certification (CPhT) is required.
• Active state pharmacy technician registration or license is required.
• High School Diploma or GED is required.
• At least 1 year of experience in a retail or call center pharmacy environment (3+ years preferred).

Responsibilities

• Evaluate and authorize Medicaid prior authorization requests by phone following defined clinical criteria.
• Determine medication appropriateness based on established guidelines and client criteria.
• Communicate PA decisions to physicians, office staff, medical management staff, and pharmacists.
• Document PA outcomes accurately in the pharmacy system.
• Explain PA criteria, coverage, and formulary alternatives to prescribers and staff.
• Escalate complex cases to a Pharmacist per escalation procedures.
• Record inquiries and outcomes, providing responses as needed.
• Process and review coverage determinations for medications received via fax.
• Communicate coverage decisions for faxed requests within SLA timeframes.
• Multitask across queues and adapt to changing workflows.
• Navigate multiple systems to research and process PA requests.
• Deliver high level customer service in a remote environment.
• Work independently in a fast-paced remote setting meeting productivity and SLA.

Skills

CPhT Certification

Active state license

Customer service

Pharmacy call center experience

Education

High School Diploma or GED

Job description

Actalent seeks a Certified Pharmacy Technician for a fully remote, contract role in Medicaid prior authorizations. You will evaluate and authorize PA requests, document outcomes, and communicate decisions to physicians and staff from a high-volume call center.

The position requires CPhT certification and an active state license, with 1+ year in retail or call center pharmacy. Training is provided and the contract may extend after one year.