Remote Medicaid Prior Authorization Pharmacy Tech

Actalent; Eagan (MN); Remote; USD 29,000 - 32,000; Full time

Benefits offered by this job

Medical

Dental & Vision

401(k) Retirement Plan

Life Insurance

PTO / Time Off

Job summary

Actalent is seeking a Fully Remote Certified Pharmacy Technician to evaluate Medicaid prior authorization requests in a high-volume call center. You’ll work primarily by phone and fax, document outcomes, and escalate complex cases to a pharmacist when needed.

The role starts as a 1-year contract with training, and may extend or convert. Remote work from anywhere in the U.S. is supported, with shifts 6:00 a.m.–9:00 p.m. CST and possible overtime during peak seasons.

Qualifications

• Active state pharmacy technician registration or license.
• National pharmacy technician certification (PTCB or NHA).
• 1 year of retail or call center pharmacy experience; 3+ years preferred.
• Experience with prior authorization processes in pharmacy settings.
• Proficient data entry with high accuracy; strong communication.
• Ability to work independently in a fast-paced remote environment.

Responsibilities

• Evaluate and authorize Medicaid prior authorization requests by phone using clinical criteria.
• Determine medication appropriateness per client guidelines and coverage rules.
• Communicate decisions clearly to physicians and staff in a professional manner.
• Document all outcomes accurately in the pharmacy system.
• Explain criteria, coverage, and formulary alternatives to prescribers.
• Escalate complex cases to a pharmacist following SOPs and SLA timelines.
• Record inquiries and provide timely results to clients and providers.

Skills

Pharmacy license

PTCB/NHA cert

Prior authorization experience

Data entry

Communication skills

Attention to detail

Multi-system navigation

Independent remote work

Customer service

Education

High school diploma or GED

Job description

Actalent is seeking a Fully Remote Certified Pharmacy Technician to evaluate Medicaid prior authorization requests in a high-volume call center. You’ll work primarily by phone and fax, document outcomes, and escalate complex cases to a pharmacist when needed.

The role starts as a 1-year contract with training, and may extend or convert. Remote work from anywhere in the U.S. is supported, with shifts 6:00 a.m.–9:00 p.m. CST and possible overtime during peak seasons.