Remote Pharmacy PA & Appeals Specialist (VT/ME)

In Balance; Portland (ME); Remote; USD 25,000 - 44,000; Full time

Benefits offered by this job

Remote work option

Comprehensive benefits

Job summary

UnitedHealth Group is seeking a Senior Pharmacy PA/Appeals Technician to support prior authorization and appeals processes. The role involves handling inquiries, reviewing requests in multiple systems, and ensuring complete documentation.

Remote work available for Maine or Vermont residents, with 8-hour shifts and on-call weekend duties. Ideal candidates have active pharmacy tech licensure (PTCB/ExCPT) and 6+ months of healthcare or customer service experience.

Qualifications

• Active pharmacy technician licensure or certification in state of residence.
• 6+ months in customer service or healthcare or call center.
• Proficient with Microsoft Office and basic systems navigation.
• Able to work 8-hour shifts 8am-8pm EST, Mon-Fri, Maine or Vermont residency.

Responsibilities

• Handle high volume inbound/outbound calls (50+ daily) with professionalism.
• Process prior authorization inquiries from providers, members, and partners.
• Review PA requests across multiple systems ensuring complete/documented info.
• Research formulary, benefits, medication, eligibility, and plan details.
• Gather and verify information for pharmacist consultation or clinical review.
• Maintain documentation and meet turnaround times and SLA expectations.

Skills

Customer service

Communication skills

Attention to detail

Time management

Regulatory knowledge

Microsoft Excel basics

Multisystem navigation

Education

Pharmacy Technician Certification (PTCB)

State licensure/registration (as required)

ExCPT Certification

Tools

Microsoft Word

Microsoft Excel

Outlook

Teams

Job description

UnitedHealth Group is seeking a Senior Pharmacy PA/Appeals Technician to support prior authorization and appeals processes. The role involves handling inquiries, reviewing requests in multiple systems, and ensuring complete documentation.

Remote work available for Maine or Vermont residents, with 8-hour shifts and on-call weekend duties. Ideal candidates have active pharmacy tech licensure (PTCB/ExCPT) and 6+ months of healthcare or customer service experience.