Remote Certified Pharmacy Technician – Prior Authorization Specialist

Actalent; United States; Remote; USD 25,000 - 30,000; Full time

Benefits offered by this job

Medical/Dental/Vision

401(k) Plan

Life Insurance

Disability Insurance

HSA

Transit benefits

EAP

PTO

Job summary

Actalent is seeking a 100% remote Certified Pharmacy Technician to evaluate and authorize commercial prior authorization requests using clinical criteria in a calls-based environment. You will document outcomes, communicate decisions, and escalate complex cases for pharmacist review.

Responsibilities include handling calls from prescribers, detailing formulary alternatives, and maintaining accurate records within the pharmacy system.

Qualifications

• 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

Prior authorization

Customer service

Call center

Pharmacy experience

Job description

Actalent is seeking a 100% remote Certified Pharmacy Technician to evaluate and authorize commercial prior authorization requests using clinical criteria in a calls-based environment. You will document outcomes, communicate decisions, and escalate complex cases for pharmacist review.

Responsibilities include handling calls from prescribers, detailing formulary alternatives, and maintaining accurate records within the pharmacy system.