Remote PBM Pharmacy Tech — Call Center Specialist

Gainwell Technologies; West Virginia; Remote; USD 36,000 - 51,000; Full time

Benefits offered by this job

Health benefits

401(k) match

Educational assistance

Generous vacation policy

Job summary

Gainwell Technologies is seeking a Pharmacy Technician for its PBM clinical and technical call center in a remote-capable setting. The role requires expertise in pharmacy knowledge and call center operations, handling inbound/outbound calls, prior authorization processing, and member/provider inquiries.

Qualified candidates will have 2 years of pharmacy technician experience, active registration or certification within 12 months, and familiarity with PHI, Microsoft Office, and basic math.

Qualifications

• Must be at least 18 years of age.
• High school diploma or GED required.
• Active pharmacy technician registration with a Board of Pharmacy or certified from accredited program (PTCB, ExCPT, etc.) or must obtain certification within 12 months.
• 2 years of relevant experience as a pharmacy technician in retail, hospital, managed care, insurance, or PBM.

Responsibilities

• Answer incoming calls and make outgoing calls to members, providers, or pharmacy providers.
• Process prior authorization requests within required time frames.
• Assist members and providers with inquiries via phone, fax, email, or web.
• Explain pharmacy claims status, rejection reasons, and coverage rules to customers.
• Document all inquiries accurately for audit and service level tracking.

Skills

Effective communication

Basic math

Medication terminology

Microsoft Office

Education

High school diploma or GED

Tools

Microsoft Office

Email client

Job description

Gainwell Technologies is seeking a Pharmacy Technician for its PBM clinical and technical call center in a remote-capable setting. The role requires expertise in pharmacy knowledge and call center operations, handling inbound/outbound calls, prior authorization processing, and member/provider inquiries.

Qualified candidates will have 2 years of pharmacy technician experience, active registration or certification within 12 months, and familiarity with PHI, Microsoft Office, and basic math.