Remote PA Pharmacy Tech (Medicare/Medicaid)

Actalent; Atlanta (GA); Remote; USD 28,000 - 32,000; Full time

Benefits offered by this job

Medical benefits

Dental & Vision

401(k) plan

Job summary

Actalent is seeking a Remote Pharmacy Technician to support Medicare and Medicaid patients by processing prior authorizations in a fully remote environment. You will intake requests, perform technical reviews, and determine coverage decisions based on established criteria and SOPs, while maintaining HIPAA compliance and delivering excellent patient service.

Responsibilities include data entry, reviewing insurance docs, and collaborating with the review team to ensure timely and accurate

Qualifications

• Active pharmacy technician certification (CPhT).
• Hands-on pharmacy technician experience in managed care or prior authorization.
• Experience with Medicare/Medicaid populations and prior authorization processes.
• Strong data entry with high accuracy and attention to detail.

Responsibilities

• Process intake of MedPharm prior authorization requests in internal systems.
• Route intake cases to review team and perform technical reviews.
• Determine coverage decisions (approval/denial/partial) based on criteria.
• Read SOPs and insurance documents to assess eligibility.
• Make clinical determinations on coverage following guidelines.
• Data entry related to claims, prior authorizations, and patient info.
• Provide professional phone support to patients and providers.
• Work remotely and independently, meeting performance standards.
• Ensure HIPAA compliance in a distraction-free setting.
• Support rotating holiday coverage and training updates.

Skills

CPhT

Prior authorization

Managed care

Data entry

Remote work

Phone support

Tools

EMR systems

Job description

Actalent is seeking a Remote Pharmacy Technician to support Medicare and Medicaid patients by processing prior authorizations in a fully remote environment. You will intake requests, perform technical reviews, and determine coverage decisions based on established criteria and SOPs, while maintaining HIPAA compliance and delivering excellent patient service.

Responsibilities include data entry, reviewing insurance docs, and collaborating with the review team to ensure timely and accurate